Interstitial preoperative high-dose-rate brachytherapy for early stage cervical cancer: Dose–volume histogram parameters, pathologic response and early clinical outcome

Hannoun‐Lévi, Jean‐Michel; Chand-Fouché, Marie-Eve; Gautier, Mathieu; Dejean, C.; Marcy, M.; Fouché, Yves

doi:10.1016/j.brachy.2012.04.007

Cited by 24 publications

(26 citation statements)

References 29 publications

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“…We summarized the results of several retrospective studies from the literature regarding the effect of preoperative BT in Table 6. With higher doses (39-75 Gy) of low-dose-rate (LDR) or HDR BT the pCR rate was from 52-88 %, while with lower doses of HDR BT the same proportion was 23-45 % [4,5,[8][9][10][11]13,17,18]. In certain institutions in more advanced stages (I/B2-II/B) the preoperative treatment is combined RT (tele+brachytherapy), with or without concomitant ChT, followed by adjuvant hysterectomy.…”

Section: Discussionmentioning

confidence: 99%

Pathologic Complete Remission after Preoperative High-Dose-Rate Brachytherapy in Patients with Operable Cervical Cancer: Preliminary Results of a Prospective Randomized Multicenter Study

Vízkeleti

Vereczkey

Fröhlich

et al. 2014

Pathol. Oncol. Res.

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The role of preoperative intrauterine brachytherapy (BT) in the multidisciplinary treatment of early stage cervical carcinoma (ESCC) is controversial. In 2005, a prospective randomized multicenter study was initiated in Hungary in order to explore the potential advantages of preoperative high-dose-rate (HDR) BT. In this article we evaluate the efficiency of preoperative HDR BT by the rate of pathologic complete remission (pCR) in the first 185 patients enrolled in the study at the National Institute of Oncology and at the Uzsoki Municipal Cancer Center in collaboration with the 1st Department of Gynaecology and Obstetrics of Semmelweis University, Budapest, Hungary. In arm A, patients received 2x8Gy preoperative intracavitary HDR BT, while in arm B no preoperative treatment was given. In both arms patients underwent radical Wertheim (Piver III) hysterectomy. The pCR rate was 25.7% after preoperative HDR BT, while it was only 11.2% with surgery alone (p=0.03), in these cases the tumor was eliminated during the diagnostic excision or conisation. The rate of positive surgical margins was 1.5% after preoperative BT, while it was as high as 11.4% without preoperative RT (p=0.02). There was no significant difference in the local tumor control (LTC), distant metastases free survival (DMFS) and overall survival (OS) between the two arms. According to our preliminary results preoperative intracavitary HDR BT significantly increases the rate of pCR and decreases the rate of positive surgical margins in patients with ESCC. Longer follow-up is required to establish the possible impact of pCR on the ultimate LTC and OS.

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Section: Discussionmentioning

confidence: 99%

Pathologic Complete Remission after Preoperative High-Dose-Rate Brachytherapy in Patients with Operable Cervical Cancer: Preliminary Results of a Prospective Randomized Multicenter Study

Vízkeleti

Vereczkey

Fröhlich

et al. 2014

Pathol. Oncol. Res.

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“…O estudo de Khor et al (2007) trabalhou com uma amostra de 106 mulheres, com análise retrospectiva de aproximadamente 59 meses (KHOR et al, 2007;GREIMEL et al, 2009;VAZ et al, 2011;HANNOUN-LEVI, 2013) e os autores descrevem a necessidade de estimular a condução de novas pesquisas clínicas sobre o processo de minimizações desses desconfortos físico-emocionais já nas fases inicias do tratamento.…”

Section: Discussionunclassified

Processo De Recuperação Físico E Emocional No Pós-Câncer Ginecológico

Toriy¹,

Pires²,

Zomkowski³

et al. 2015

CTO

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Resumo: Introdução: O câncer ginecológico é uma doença que abrange as malignidades do colo uterino, dos ovários, do endométrio e da vagina ou vulva, sendo considerado um problema de saúde pública, visto que há declínio na qualidade de vida (QV). Objetivo: Identificar as implicações físico-emocionais e comparar a qualidade de vida na pré e na pós-braquiterapia. Método: Estudo prospectivo com abordagem qualiquantitativa. Foi realizado no Centro de Pesquisas Oncológicas e foram avaliadas 20 mulheres sobreviventes do câncer ginecológico entre 18 e 70 anos (49,55 ± 16,98). Utilizou-se o instrumento EORTC QLQ -C30 para avaliar a QV e a entrevista semiestruturada com perguntas acerca da problemática. Resultados: As características sociodemográficas demonstraram predominância no diagnostico de câncer de colo de útero, com estadiamento tipo IIB. Com relação à qualidade de vida, observou-se diferença significativa após a braquiterapia nos itens Constipação (p= 0,027) e Diarreia (p= 0,004). Os domínios função física, emocional, cognitiva, social e desempenho de papéis tiveram decréscimo das funções. Os temas construídos a partir da análise das verbalizações foram: 1) alterações físicas: a) lidando com a dor e o sofrimento; b) enfrentando as dificuldades físicas; 2) alterações emocionais: a) superando a ansiedade, medo, angústia e depressão; b) enfrentando as implicações emocionais, e 3) alterações físico-emocionais. Conclusão: As implicações emocionais proporcionam um impacto importante na resposta física. As alterações no estado de saúde em geral e na qualidade de vida destas mulheres após a braquiterapia determinam a necessidade de readequar práticas cotidianas estimuladas por multiprofissionais da saúde. Palavras-chave: Qualidade de Vida, Braquiterapia, Atividades Cotidianas. Process of physical and emotional recovery in post-gynecological cancerAbstract: Introduction: The gynecological cancer is a disease that includes the malignancies of the cervix, ovaries, endometrium, vagina or vulva and is considered a public health problem, as it reduces the quality of life (QOL). Objective: To identify the physical and emotional implications and compare the quality of life in pre-and post-brachytherapy. Method: Prospective study with qualitative and quantitative approach. The study was held at the Oncology Research Center and 20 women survivors of gynecological cancer between 18 and 70 years were evaluated. We used the EORTC QLQ instrument -C30 to assess QOL and semi -structured interview with questions on the issue. Results: The sociodemographic features showed predominance in the diagnosis of cervical cancer, with type IIB staging. Regarding quality of life, it was observed a significant post-brachytherapy difference in constipation (p = 0.027) and diarrhea (p = 0.004). The physical function, emotional, cognitive, social and role play domains had a decrease of function. The themes built from the analysis of utterances were: 1) physical changes: a) dealing Processo de recuperação físico-emocional no pós-câncer ginecológico

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“…Low and pulsed-dose rate (PDR) brachytherapy represented until recent years the reference technique [15,16]. However, the evolution of brachytherapy techniques, after-loading machines, treatment planning software and more stringent rules of radiation safety have positioned high-dose rate brachytherapy as the reference technique for numerous indication such cervical and prostate tumors [5-7,15,17]. But clinical data of HDR brachytherapy for penis cancer remains rare.…”

Section: Discussionmentioning

confidence: 99%

“…An interval of at least 6 hours was observed between the 2 daily fractions. This regimen was adapted from a series of preoperative HDR brachytherapy used for cervical cancer for which a total dose of 39 Gy in 9 fractions was delivered over 5 days leading to a complete pathological response rate observed on the post-operative specimen of 92% for squamous cell carcinoma [5]. …”

Section: Methodsmentioning

confidence: 99%

“…For radioprotection and dose distribution optimization considerations as well as therapeutic comfort of the patient, high-dose rate brachytherapy (HDB) has become a standard treatment in many cancers (cervical [5], breast [6] and prostate [7]). The aim of our study was to evaluate the clinical outcome of HDB for penile cancers classified T1a, T1b or T2 < 4 cm according to the TNM 2009 [8].…”

Section: Introductionmentioning

confidence: 99%

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High-dose rate brachytherapy in localized penile cancer: short-term clinical outcome analysis

et al. 2014

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PurposeTo assess clinical outcomes of high-dose rate interstitial brachytherapy (HIB) in localized penile carcinoma.Material and methodsFrom 03/2006 to 08/2013, patients with biopsy-proven T1-T2 (<4 cm) non-metastatic localized penile squamous cell carcinoma underwent HIB. Under general anaesthesia, after Foley catheter placement, needles were placed in the target volume using a dedicated template. Planification was carried out with a post-implant CT-scan to deliver a total dose of 36 Gy in 9 fractions over 5 days (in adjuvant setting) or 39 Gy in 9 fractions over 5 days (as monotherapy). Dose-volume adaptation was manually achieved using graphical optimization. Dosimetric data and clinical outcomes were retrospectively analyzed. Toxicities were graded using the CTC v4.0.ResultsWith a median follow-up of 27 months [5.1-83], 12 patients including 8 T1a, 3 T1b and 1 T2 N0 underwent HIB (sole therapy: 11 pts; adjuvant: 1 pt). The actuarial 5-year relapse-free, cause-specific and overall survival rates were 83%, 100% and 78% respectively. Comparing pre and post treatment evaluation, no IPSS or IIEF-5 changes were reported. Dermatitis was reported systematically 1 month after HIB including 6 G1, 5 G2 and 1 G3. Only 1 experienced long-term G3 successfully treated with hyperbaric oxygen therapy. One urethral meatus stenosis G3 required meatotomy.ConclusionIn selected patients with T1-T2 localized penile cancer, HIB may be considered as an optional conservative therapy. Longer follow-up is needed to confirm these encouraging preliminary results.

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Interstitial preoperative high-dose-rate brachytherapy for early stage cervical cancer: Dose–volume histogram parameters, pathologic response and early clinical outcome

Cited by 24 publications

References 29 publications

Pathologic Complete Remission after Preoperative High-Dose-Rate Brachytherapy in Patients with Operable Cervical Cancer: Preliminary Results of a Prospective Randomized Multicenter Study

Pathologic Complete Remission after Preoperative High-Dose-Rate Brachytherapy in Patients with Operable Cervical Cancer: Preliminary Results of a Prospective Randomized Multicenter Study

Processo De Recuperação Físico E Emocional No Pós-Câncer Ginecológico

High-dose rate brachytherapy in localized penile cancer: short-term clinical outcome analysis

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