Toward four-dimensional image-guided adaptive brachytherapy in locally recurrent endometrial cancer
| Autor: | Kari Tanderup, Erik Morre Pedersen, Gitte Ørtoft, Lars Fokdal, Estrid S. Hansen, Lisbeth Røhl, Jacob Christian Lindegaard |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Oncology
Adult Organs at Risk medicine.medical_specialty medicine.medical_treatment Brachytherapy Planning target volume Rectum Disease-Free Survival Internal medicine medicine Humans Radiology Nuclear Medicine and imaging In patient External beam radiotherapy Small tumors Survival rate Aged Aged 80 and over business.industry Radiotherapy Dosage Middle Aged Recurrent Endometrial Cancer Magnetic Resonance Imaging Endometrial Neoplasms Survival Rate medicine.anatomical_structure Treatment Outcome Female Radiology Neoplasm Recurrence Local Radiotherapy Conformal business |
| Zdroj: | Fokdal, L, Ørtoft, G, Hansen, E S, Røhl, L, Pedersen, E M, Tanderup, K & Lindegaard, J C 2014, ' Toward four-dimensional image-guided adaptive brachytherapy in locally recurrent endometrial cancer ', Brachytherapy, vol. 13, no. 6, pp. 554-61 . https://doi.org/10.1016/j.brachy.2014.06.004 |
| ISSN: | 1873-1449 |
| DOI: | 10.1016/j.brachy.2014.06.004 |
| Popis: | PURPOSE: To evaluate clinical outcome and feasibility of a four-dimensional image-guided adaptive brachytherapy concept in patients with locally recurrent endometrial cancer.METHODS AND MATERIALS: Forty-three patients with locally recurrent endometrial cancer were included. Treatment consisted of conformal external beam radiotherapy followed by a boost using pulsed-dose-rate brachytherapy (BT). Large tumors were treated with MRI-guided interstitial BT. Small tumors were treated with CT-guided intracavitary BT. The planning aim (total external beam radiotherapy and BT) for high-risk clinical target volume was D90 > 80 Gy, whereas constraints for organs at risk were D2cc ≤ 90 Gy for bladder and D2cc ≤ 70 Gy for rectum, sigmoid, and bowel in terms of equivalent dose in 2 Gy fractions.RESULTS: Median high-risk clinical target volume was 18 cm(3) (range, 0-91). D90 was 82 Gy (range, 77-88). D2cc to bladder, rectum, and sigmoid were 67 Gy (range, 50-81), 67 Gy (range, 51-77), and 55 Gy (range, 44-68), respectively. Median followup was 30 months (6-88). Two-year local control rate was 92% (standard error [SE], 5). Disease-free survival rate and overall survival rate was 59% (SE, 8) and 78% (SE, 7), respectively. Patients with low- to intermediate-risk for recurrence had a 2-year disease-free survival rate of 72% (SE, 9) compared with 42% (SE, 12) in patients with high risk for recurrence (p = 0.04). Late morbidity Grade 3 was recorded in 5 (12%) patients.CONCLUSIONS: Four-dimensional image-guided adaptive brachytherapy is feasible in locally recurrent endometrial cancer. Local control rate is good. Systemic control remains a problem in patients with high risk for recurrence. |
| Databáze: | OpenAIRE |
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