Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences.

Autor: Vojtíšek R; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic. vojtisekr@fnplzen.cz., Hošek P; Biomedical Center, Charles University in Prague, Faculty of Medicine in Pilsen, alej Svobody 76, 323 00, Pilsen, Czech Republic., Sukovská E; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic., Kovářová P; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic., Baxa J; Department of Imaging Methods, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic., Ferda J; Department of Imaging Methods, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic., Fínek J; Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic.
Jazyk: angličtina
Zdroj: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] [Strahlenther Onkol] 2022 Sep; Vol. 198 (9), pp. 783-791. Date of Electronic Publication: 2022 Jan 21.
DOI: 10.1007/s00066-021-01887-x
Abstrakt: Purpose: Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late toxicities, and dosimetric findings.
Methods: Between May 2012 and October 2020, we performed a total of 544 uterovaginal IGABT applications in 131 consecutive patients with biopsy-proven cervical carcinoma not suitable for surgery. The median duration of follow-up was 43 months.
Results: The estimated 3‑, 4‑, and 5‑year LC rates were 88.3% (95% confidence interval [CI] 81.1-95.5), 86.9% (95% CI 78.5-95.3), and 85.5% (95% CI 76-95%), respectively. The 3‑, 4‑, and 5‑year OS estimates were 72.66% (95% CI 63.64-81.69%), 68.9% (95% CI 59.15-78.66%), and 63.96% (95% CI 52.94-74.97%), respectively. Patients who received ≥ 5 cycles of chemotherapy had statistically significantly better 3‑year recurrence-free survival (RFS) compared to patients who completed <5 cycles (79.07% [95% CI 60.81-97.34] vs. 58.10% [95% CI 47.22-68.98]; p = 0.0185). We recorded manifestations of genitourinary and gastrointestinal toxicity grade ≥3 in 6.9% and 5.3%, respectively.
Conclusion: Our mature long-term data on the treatment patients with locally advanced cervical cancer show that excellent treatment outcomes can be achieved with MRI-based IGABT, as well as acceptable late morbidity.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
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