Recommendations for image-based intracavitary brachytherapy of cervix cancer: The GYN GEC ESTRO Working Group point of view: In regard to Nag et al. (Int J Radiat Oncol Biol Phys 2004;60:1160–1172)

Pötter, Richard; Dimopoulos, Johannes; Kirisits, Christian; Lang, Stefan; Haie-Méder, Christine; Briot, E.; Dumas, Isabelle; Limbergen, Erik; Brabandere, Marisol De; Nulens, A.; Erickson, Beth; Rownd, Jason; Petrow, Peter

doi:10.1016/j.ijrobp.2005.01.036

Cited by 35 publications

(17 citation statements)

References 7 publications

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“…First, the number of cases and the retrospective study design make any statistical conclusions very tentative. Second, our brachytherapy system was not image-based, so could not provide the 1 cm 3 , 2 cm 3 , and 5 cm 3 volumes for the bladder, intestines, and rectum 33,34. However, we compared the data for all patients, including those treated with whole pelvic IMRT or helical tomotherapy followed by brachytherapy.…”

Section: Discussionmentioning

confidence: 99%

Helical tomotherapy provides efficacy similar to that of intensity-modulated radiation therapy with dosimetric benefits for endometrial carcinoma

Hsieh¹,

Shueng²,

Hsiao³

et al. 2012

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BackgroundThe purpose of this study was to compare the efficacy of intensity-modulated radiotherapy (IMRT) and helical tomotherapy for endometrial cancer.MethodsBetween November 1, 2006 and November 31, 2010, 31 patients with histologically confirmed endometrial cancer were enrolled. All enrolled patients received total abdominal hysterectomy and bilateral salpingo-oophorectomy with adjuvant whole pelvic IMRT or helical tomotherapy.ResultsThe actuarial 3-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates for the IMRT and helical tomotherapy groups were 87.5% versus 100%, 91.7% versus 51.7%, 91.7% versus 83.3%, and 91.7% versus 51.7%, respectively. The conformal index and uniformity index for IMRT versus helical tomotherapy was 1.25 versus 1.17 (P = 0.04) and 1.08 versus 1.05 (P < 0.01), respectively. Two of 31 patients with cervical stump failure were noted, one in the IMRT group and the other in the helical tomotherapy group. No acute or late grade 3 or 4 toxicities were noted, including proctitis, or genitourinary or gastrointestinal disturbances.ConclusionHelical tomotherapy is as effective as IMRT and has better uniformity and conformal indices, and critical organ-sparing properties. Prospective clinical trials are needed to evaluate the comparative efficacy of IMRT versus helical tomotherapy.

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Section: Discussionmentioning

confidence: 99%

Helical tomotherapy provides efficacy similar to that of intensity-modulated radiation therapy with dosimetric benefits for endometrial carcinoma

Hsieh¹,

Shueng²,

Hsiao³

et al. 2012

OTT

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“…The MR-defined-CTV (MR-CTV), which was identical to the GEC-ESTRO defined HR-CTV, 18 included the entire cervix as seen on MR plus any parametrial or vaginal extension (called ‘gray zones’ by the GEC-ESTRO nomenclature on a low-Tesla MR scan) 22 seen on MRI and on clinical examination at the time of BT. 17 The Steering Committee determined that physicians would not be asked to contour the GTV or other structures as the primary focus was on comparison of CT-CTV to MR-CTV.…”

Section: Methodsmentioning

confidence: 99%

Comparison and Consensus Guidelines for Delineation of Clinical Target Volume for CT- and MR-Based Brachytherapy in Locally Advanced Cervical Cancer

Viswanathan

Erickson

Gaffney

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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141

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Purpose/Objective To create and compare consensus clinical target volume (CTV) contours for computed tomography (CT) and 3 Tesla (3T) magnetic resonance (MR) image-based cervical-cancer brachytherapy Materials/Methods Twenty-three gynecologic radiation oncology experts contoured the same 3 cervical-cancer brachytherapy cases: one Stage IIB near-complete response (CR) case with a tandem and ovoid, one Stage IIB partial response (PR) case with ovoid with needles and one Stage IB2 CR case with a ring applicator. CT contours were completed before MRI contours. These were analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with kappa statistics as a measure of agreement between participants. The conformity index (CI) was calculated for each of the six data sets. Dice coefficients were generated to compare CT and MR contours of the same case. Results For all 3 cases, the mean tumor volume was smaller on MR than on CT (p<0.001). Kappa and CI estimates were slightly higher for CT, indicating a higher level of agreement on CT. DICE coefficients were 89% for the Stage IB2 case with a CR, 74% for the Stage IIB case with a PR, and 57% for the Stage IIB case with a CR. Conclusion When comparing MR- to CT-contoured CTV volumes, the higher level of agreement on CT may be due to the more distinct contrast visible on the images at the time of brachytherapy. The largest difference at the time of brachytherapy was in the case with parametrial extension at diagnosis that had a near-complete response, due to the appearance of the parametria on CT but not on MR. Based on these results, a 95% consensus volume was generated for CT and for MR. Online contouring atlases are available for instruction at http://www.nrgoncology.org/Resources/ContouringAtlases.aspx.

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“…GEC-ESTRO recommendations are based on three-dimensional definitions of gross tumor volume (GTV), CTV, and planning target volume (PTV) (6,7,33). On the basis of pre-brachytherapy MRI scans, the GTV is delineated by the T2 hyperintense areas.…”

Section: Treatment Volumementioning

confidence: 99%

Does the Entire Uterus Need to be Treated in Cancer of the Cervix? Role of Adaptive Brachytherapy

Anker

Cachoeira

Boucher

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Recommendations for image-based intracavitary brachytherapy of cervix cancer: The GYN GEC ESTRO Working Group point of view: In regard to Nag et al. (Int J Radiat Oncol Biol Phys 2004;60:1160–1172)

Cited by 35 publications

References 7 publications

Helical tomotherapy provides efficacy similar to that of intensity-modulated radiation therapy with dosimetric benefits for endometrial carcinoma

Helical tomotherapy provides efficacy similar to that of intensity-modulated radiation therapy with dosimetric benefits for endometrial carcinoma

Comparison and Consensus Guidelines for Delineation of Clinical Target Volume for CT- and MR-Based Brachytherapy in Locally Advanced Cervical Cancer

Does the Entire Uterus Need to be Treated in Cancer of the Cervix? Role of Adaptive Brachytherapy

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