Prospective Multi-Institutional Study of Definitive Radiotherapy With High-Dose-Rate Intracavitary Brachytherapy in Patients With Nonbulky (&lt;4-cm) Stage I and II Uterine Cervical Cancer (JAROG0401/JROSG04-2)

Toita, Takafumi; Kato, Shingo; Niibe, Yuzuru; Ohno, Tatsuya; Kazumoto, Tomoko; Kodaira, Takeshi; Kataoka, Makoto; Shikama, Naoto; Kenjo, Masahiro; Tokumaru, Sunao; Yamauchi, Chikako; Сузукі, Осаму; Sakurai, Hideyuki; Numasaki, Hodaka; Teshima, Teruki; Oguchi, Masahiko; Kagami, Yoshikazu; Nakano, Takashi; Hiraoka, Masahiro; Mitsuhashi, Norio

doi:10.1016/j.ijrobp.2011.01.022

Cited by 61 publications

(43 citation statements)

References 37 publications

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“…Toita et al . showed the efficacy of treatment schedule with CS in a series of multicenter prospective clinical trials [35, 36], and our group demonstrated favorable results with schedule with CS in CT based 3D image-guided brachytherapy [16]. …”

Section: Discussionmentioning

confidence: 99%

The role of interstitial brachytherapy in the management of primary radiation therapy for uterine cervical cancer

Murakami¹,

Kobayashi²,

Kato

et al. 2016

jcb

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PurposeThe aim of this study was to report the clinical results of uterine cervical cancer patients treated by primary radiation therapy including brachytherapy, and investigate the role of interstitial brachytherapy (ISBT).Material and methodsAll consecutive uterine cervical cancer patients who were treated by primary radiation therapy were reviewed, and those who were treated by ISBT were further investigated for clinical outcomes and related toxicities.ResultsFrom December 2008 to October 2014, 209 consecutive uterine cervical cancer patients were treated with primary radiation therapy. Among them, 142 and 42 patients were treated by intracavitary and hybrid brachytherapy, respectively. Twenty-five patients (12%) were treated by high-dose-rate (HDR)-ISBT. Five patients with distant metastasis other than para-aortic lymph node were excluded, and 20 patients consisted of the analysis. Three-year overall survival (OS), progression-free survival (PFS), and local control (LC) rate were 44.4%, 38.9%, and 87.8%, respectively. Distant metastasis was the most frequent site of first relapse after HDR-ISBT. One and four patients experienced grade 3 and 2 rectal bleeding, one grade 2 cystitis, and two grade 2 vaginal ulcer.ConclusionsFeasibility and favorable local control of interstitial brachytherapy for locally advanced cervical cancer was demonstrated through a single institutional experience with a small number of patients.

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Section: Discussionmentioning

confidence: 99%

The role of interstitial brachytherapy in the management of primary radiation therapy for uterine cervical cancer

Murakami¹,

Kobayashi²,

Kato

et al. 2016

jcb

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“…It has been known that Japanese centers use lower cumulative dose schedules with shorter overall treatment time (OTT) than those of US and Europe [27,28]. Recently Toita et al showed the efficacy of Japanese schedule in a series of multicenter prospective trials in which Stage I and II with small (<4 cm) tumor diameter can be effectively treated by BED 62 Gy 10 (JAROG0401/JROSG04-2) [29] and Stage III/IVA by BED 62–65 Gy 10 at point A (JCOG1066) [30]. Therefore it is reasonable that in current study the cut-off value is much lower than Vienna group.…”

Section: Discussionmentioning

confidence: 99%

CT based three dimensional dose-volume evaluations for high-dose rate intracavitary brachytherapy for cervical cancer

et al. 2014

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BackgroundIn this study, high risk clinical target volumes (HR-CTVs) according to GEC-ESTRO guideline were contoured retrospectively based on CT images taken at the time of high-dose rate intracavitary brachytherapy (HDR-ICBT) and correlation between clinical outcome and dose of HR-CTV were analyzed.MethodsOur study population consists of 51 patients with cervical cancer (Stages IB-IVA) treated with 50 Gy external beam radiotherapy (EBRT) using central shield combined with 2–5 times of 6 Gy HDR-ICBT with or without weekly cisplatin. Dose calculation was based on Manchester system and prescribed dose of 6 Gy were delivered for point A. CT images taken at the time of each HDR-ICBT were reviewed and HR-CTVs were contoured. Doses were converted to the equivalent dose in 2 Gy (EQD2) by applying the linear quadratic model (α/β = 10 Gy).ResultsThree-year overall survival, Progression-free survival, and local control rate was 82.4%, 85.3% and 91.7%, respectively. Median cumulative dose of HR-CTV D90 was 65.0 Gy (52.7-101.7 Gy). Median length from tandem to the most lateral edge of HR-CTV at the first ICBT was 29.2 mm (range, 18.0-51.9 mm). On univariate analysis, both LCR and PFS was significantly favorable in those patients D90 for HR-CTV was 60 Gy or greater (p = 0.001 and 0.03, respectively). PFS was significantly favorable in those patients maximum length from tandem to edge of HR-CTV at first ICBT was shorter than 3.5 cm (p = 0.042).ConclusionVolume-dose showed a relationship to the clinical outcome in CT based brachytherapy for cervical carcinoma.

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“…For example, in the ACT I UKCCCR Anal Cancer Trial (1996), patients were treated with 45 Gy in 20e25 fractions to the pelvis (anus up to the mid-pelvic line to include the inguinal lymph nodes), which was subsequently followed by 15 Gy in six fractions to the perineal field with electrons or photons, or by an iridium-192 implant to 25 Gy at 10 Gy per day [43]. Similar techniques can be cited for cervical cancer [44,45], head and neck cancer [46,47] and prostate cancer [48,49]. In these examples the choice of the volume for the boost was not based on any biological information, but instead it was determined by the area perceived to be at Examples of doseeresponse curves for individuals with relatively resistant tumours (blue) and for individuals with relatively sensitive tumours (orange).…”

Section: Rationale For Biologically Optimised Radiotherapymentioning

confidence: 99%

Functional Radiotherapy Targeting using Focused Dose Escalation

Alonzi

2015

Clinical Oncology

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Prospective Multi-Institutional Study of Definitive Radiotherapy With High-Dose-Rate Intracavitary Brachytherapy in Patients With Nonbulky (<4-cm) Stage I and II Uterine Cervical Cancer (JAROG0401/JROSG04-2)

Cited by 61 publications

References 37 publications

The role of interstitial brachytherapy in the management of primary radiation therapy for uterine cervical cancer

The role of interstitial brachytherapy in the management of primary radiation therapy for uterine cervical cancer

CT based three dimensional dose-volume evaluations for high-dose rate intracavitary brachytherapy for cervical cancer

Functional Radiotherapy Targeting using Focused Dose Escalation

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