MRI Guided High-dose-rate Vaginal Interstitial Brachytherapy for Locally Recurrent Endometrial Cancers

Patil, Nikhilesh; Hajdok, George; Surry, Kathleen; McBrayne, Gail; Sugimoto, Akira; Préfontaine, Michel; Derrah, L.; Murray, T.; Lum, Aaron F.H.; D’Souza, David

doi:10.1016/j.ijrobp.2012.07.1215

Cited by 2 publications

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“…Imaging in gynecologic radiation planning has resulted in remarkable improvement in the identification and delineation of a target volume (10, 27–29). Three-dimensional imaging modalities currently in use include computed tomography (CT) scan, and magnetic resonance imaging (MRI).…”

Section: Introductionmentioning

confidence: 99%

MR- versus CT-based high-dose-rate interstitial brachytherapy for vaginal recurrence of endometrial cancer

et al. 2017

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Purpose To compare clinical outcomes of MR-based versus CT-based high-dose-rate (HDR) interstitial brachytherapy (ISBT) for vaginal recurrence of endometrioid endometrial cancer (EC). Methods We reviewed 66 patients with vaginal recurrent EC; 18 had MR-based ISBT on a prospective clinical trial and 48 had CT-based treatment. Kaplan-Meier (K-M) survival modeling was used to generate estimates for local control (LC), disease-free interval (DFI), and overall survival (OS) and multivariate Cox modeling was used to assess prognostic factors. Toxicities were evaluated and compared. Results Median follow up was 33 months (CT 30 months, MR 35 months). Median cumulative EQD2 was 75.5 Gy for MR-ISBT and 73.8 Gy for CT-ISBT (p=0.58). MR patients were older (p=0.03) and had larger tumor size (>4cm vs ≤4cm) compared to CT patients (p=0.04). For MR- vs. CT-based ISBT, 3-year KM rate for LC was 100% vs. 78% (p = 0.04), DFI was 69% vs. 55% (p= 0.1), and OS was 63% vs. 75% (p= 0.81), respectively. On multivariate analysis, tumor grade 3 was associated with worse OS (HR 3.57, 95%CI 1.25,11.36) in a model with MR-ISBT (HR=0.56, 95%CI 0.16,1.89). Toxicities were not significantly different between the two modalities. Conclusion Despite worse patient prognostic features, MR-ISBT was associated with a significantly better (100%) 3-year local control, comparable survival, and improved DFI rates compared to CT. Toxicities did not differ compared to CT-ISBT patients. Tumor grade contributed as the most significant predictor for survival. Larger prospective studies are needed to assess the impact of MR-ISBT on survival outcomes.

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Section: Introductionmentioning

confidence: 99%

MR- versus CT-based high-dose-rate interstitial brachytherapy for vaginal recurrence of endometrial cancer

et al. 2017

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“…For over a decade, evidence supports that 3-dimensional (3D) imaging with ultrasound, CT or MRI in gynecological brachytherapy planning improves the identification and delineation of a target volume [13–15]. The American Brachytherapy Society Consensus Guidelines for interstitial brachytherapy for vaginal cancer recommend the use of image-guided BT to optimize dose delivery to the target tissue and minimize dose to the organs at risk [4, 9].…”

Section: Introductionmentioning

confidence: 99%

Outcomes with image-based interstitial brachytherapy for vaginal cancer

Manuel

Cho

Catalano

et al. 2016

Radiotherapy and Oncology

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PURPOSE To compare clinical outcomes of image-based versus non-image-based interstitial brachytherapy (IBBT) for vaginal cancer METHODS AND MATERIALS Of 72 patients with vaginal cancer treated with brachytherapy (BT), 47 had image guidance (CT=31, MRI=16) and 25 did not. Kaplan-Meier (KM) estimates were generated for any recurrence, local control (LC), disease-free interval (DFI), and overall survival (OS) and Cox models were used to assess prognostic factors. RESULTS Median age was 66 and median follow-up time was 24 months. Median cumulative EQD2 dose was 80.8 Gy in the non-IBBT group and 77 Gy in the IBBT group. For non-IBBT versus IBBT, the 2-year KM LC was 71% vs. 93% (p=0.03); DFI was 54% vs. 86% (p=0.04); and OS 52% vs. 82% (p=0.35). On multivariate analysis, IBBT was associated with better DFI (HR 0.24, 95% CI 0.07–0.73). Having any 2 or more of chemotherapy, high-dose-rate (HDR) BT or IBBT (temporally correlated variables) significantly reduced risk of relapse (HR=0.33, 95% CI= 0.13–0.83), compared to having none of these factors. CONCLUSION Over time, the use of chemotherapy, HDR and IBBT has increased in vaginal cancer. The combination of these factors resulted in the highest rates of disease control. Image-guided brachytherapy for vaginal cancer patients maximizes disease control.

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MRI Guided High-dose-rate Vaginal Interstitial Brachytherapy for Locally Recurrent Endometrial Cancers

Cited by 2 publications

References 0 publications

MR- versus CT-based high-dose-rate interstitial brachytherapy for vaginal recurrence of endometrial cancer

MR- versus CT-based high-dose-rate interstitial brachytherapy for vaginal recurrence of endometrial cancer

Outcomes with image-based interstitial brachytherapy for vaginal cancer

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