Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

Hsieh, Chen‐Hsi; Wei, Ming-Chow; Hsu, Yao-Peng; Chong, Ngot-Swan; Chen, Yu-Jen; Hsiao, Sheng‐Mou; Hsieh, Yen‐Ping; Wang, Li Ying; Shueng, Pei‐Wei

doi:10.1186/1471-2407-10-637

Cited by 27 publications

(21 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior studies have evaluated the ability of external beam techniques to mimic brachytherapy plans; however, these studies included fewer patients and used only a single external beam technique (Wahab et al, 2004; Hsieh et al, 2010; Cengiz et al, 2012; Haas et al, 2012). We focused on a cohort of 20 patients and analyzed both volumetric and classical point dose endpoints to compare and contrast previously treated brachytherapy plans with three external beam techniques: volumetric modulated arc therapy (VMAT, Rapid Arc, Varian Medical Systems, Palo Alto, CA, USA), intensity-modulated radiotherapy (IMRT, Varian Medical Systems, Palo Alto, CA, USA), and TomoTherapy (Accuray, Inc., Sunnyvale, CA, USA).…”

Section: Introductionmentioning

confidence: 99%

Is there a role for an external beam boost in cervical cancer radiotherapy?†

Sethi¹,

Jozsef²,

Grew³

et al. 2013

Front. Oncol.

View full text Add to dashboard Cite

Objectives: Some patients are medically unfit for or averse to undergoing a brachytherapy boost as part of cervical cancer radiotherapy. In order to be able to definitively treat these patients, we assessed whether we could achieve a boost plan that would mimic our brachytherapy plans using external beam radiotherapy.Methods: High dose rate brachytherapy plans of 20 patients with stage IIB cervical cancer treated with definitive chemoradiotherapy were included in this study. Patients had undergone computer tomography (CT) simulations with tandem and ovoids in place. Point “A” dose was 600–700 cGy. We attempted to replicate the boost dose distribution from brachytherapy plans using intensity-modulated radiotherapy (Varian Medical Systems, Palo Alto, CA, USA), volumetric modulated arc therapy (Rapid Arc, Varian Medical Systems, Palo Alto, CA, USA), or TomoTherapy (Accuray, Inc., Sunnyvale, CA, USA) with the brachytherapy 100% isodose line as our target. Target coverage, normal tissue dose, and brachytherapy point doses were compared with ANOVA. Two-sided p-values ≤0.05 were considered significant.Results: External beam plans had excellent planning target volume (PTV) coverage, with no difference in mean PTV V95% among planning techniques (range 98–100%). External beam plans had lower bladder Dmax, small intestine Dmax, and vaginal mucosal point dose than brachytherapy plans, with no difference in bladder point dose, mean bladder dose, mean small intestine dose, or rectal dose. Femoral head dose, parametria point dose, and pelvic sidewall point dose were higher with external beam techniques than brachytherapy.Conclusions: External beam plans had comparable target coverage and potential for improved sparing of most normal tissues compared to tandem and ovoid brachytherapy.

show abstract

Section: Introductionmentioning

confidence: 99%

Is there a role for an external beam boost in cervical cancer radiotherapy?†

Sethi¹,

Jozsef²,

Grew³

et al. 2013

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…Hsieh et al [37]. reported the successful use of helical tomotherapy in a patient with cervical carcinoma in whom large intrauterine leiomyomas precluded the use of standard brachytherapy.…”

Section: Recent Modalities With Encouraging Prospectsmentioning

confidence: 99%

Műllerian duct anomalies and their effect on the radiotherapeutic management of cervical cancer

Rastogi¹,

Revannasiddaiah²,

Thakur³

et al. 2013

Chin J Cancer

View full text Add to dashboard Cite

Radiotherapy plays a major role in the treatment of cervical cancer. A successful radiotherapy program integrates both external beam and brachytherapy components. The principles of radiotherapy are strongly based on the anatomy of the organ and patterns of local and nodal spread. However, in patients with distorted anatomy, several practical issues arise in the delivery of optimal radiotherapy, especially with brachytherapy. Müllerian duct anomalies result in congenital malformations of the female genital tract. Though being very commonly studied for their deleterious effects on fertility and pregnancy, they have not been recognized for their potential to interfere with the delivery of radiotherapy among patients with cervical cancer. Here, we discuss the management of cervical cancer among patients with Müllerian duct anomalies and review the very sparse amount of published literature on this topic.

show abstract

“…Innovative technology effectively pairing clinical radiation accelerators to helical scanners (Tomotherapy [25,26]) or to robotic arm mounts (Cyberknife®, [27][28][29][30]) with respiratory gating [31,32] has been a market force for recently-realized radiotherapeutic gains in gynecologic radiation oncology [33]. For purposes of discussion here, the subclass of stereotactic radiosurgery dealing with robotics [Cyberknife®, Accuray (Sunnyvale, CA, USA)] will be the focus given the preponderance of clinical data accumulated worldwide [27][28][29][30].…”

Section: Rationale For Use In Gynecologic Malignanciesmentioning

confidence: 99%

Stereotactic body radiation therapy in head and neck, gynecologic, and pediatric malignancies

2012

View full text Add to dashboard Cite

Stereotactic body radiotherapy (SBRT) is increasingly being used in the clinic. While most data from this new technology has been in the treatment of early stage lung cancer and sites of oligometastasis in the lung, liver or bone, limited experience exists in other disease sites. Recently, more and more physicians are using SBRT for retreatment. In the head and neck, multiple articles have now been published reporting outcomes in patients with recurrence or those with new primary lesions in previously irradiated areas. The response rates to SBRT have been good; however, long-term control and toxicity are still a major problem. In gynecological malignancies, the literature on SBRT is more limited with initial experience treating para-aortic nodal metastasis from cervical and uterine cancer with excellent local control. Current studies are underway utilizing SBRT with the inclusion of chemotherapy in the treatment regimen of metastatic gynecologic cancers. In pediatrics, where problems of late toxicity are a concern, there is scant information. With all these advances, long-term follow-up is needed to look at complication rates with this form of treatment. In this review, we will discuss the rationale and possible applications of SBRT in head and neck, gynecological, and pediatric tumors. We will outline the advantages and disadvantages including possible complications of SBRT. We will also present some illustrative cases on how we have used this technology in our practice.

show abstract

Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

Cited by 27 publications

References 25 publications

Is there a role for an external beam boost in cervical cancer radiotherapy?†

Is there a role for an external beam boost in cervical cancer radiotherapy?†

Műllerian duct anomalies and their effect on the radiotherapeutic management of cervical cancer

Stereotactic body radiation therapy in head and neck, gynecologic, and pediatric malignancies

Contact Info

Product

Resources

About