Results of image guided brachytherapy for stage IB cervical cancer in the RetroEMBRACE study
| Autor: | E. Villafranca, Christian Kirisits, Richard Pötter, Umesh Mahantshetty, Li Tee Tan, C. Gillham, Kari Tanderup, Jacob Christian Lindegaard, Primoz Petric, Erik Van Limbergen, Kathrin Kirchheiner, Lars Fokdal, Christine Haie-Meder, Peter Hoskin, Ina M. Jürgenliemk-Schulz, Ekkasit Tharavichitkul, Alina Sturdza, Maximilian Schmid |
|---|---|
| Přispěvatelé: | University of Zurich, Petric, Primoz |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Brachytherapy 2720 Hematology Uterine Cervical Neoplasms Rectum 610 Medicine & health Nuclear Medicine and imaging 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cervix cancer medicine Carcinoma Adjuvant therapy Humans 2741 Radiology Nuclear Medicine and Imaging Radiology Nuclear Medicine and imaging External beam radiotherapy Stage (cooking) Neoplasm Staging Cervical cancer Chemotherapy Image guided brachytherapy business.industry Radiotherapy Dosage Chemoradiotherapy Hematology Middle Aged medicine.disease 10044 Clinic for Radiation Oncology Treatment Outcome medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female 2730 Oncology Radiology business |
| Zdroj: | Petric, P, Lindegaard, J C, Sturdza, A, Fokdal, L, Kirchheiner, K, Tan, L T, Schmid, M P, Haie-Meder, C, Jürgenliemk-Schulz, I M, van Limbergen, E, Hoskin, P, Gillham, C, Tharavichitkul, E, Mahantshetty, U, Villafranca, E, Tanderup, K, Kirisits, C & Pötter, R 2021, ' Results of image guided brachytherapy for stage IB cervical cancer in the RetroEMBRACE study ', Radiotherapy and Oncology, vol. 157, pp. 24-31 . https://doi.org/10.1016/j.radonc.2021.01.005 |
| Popis: | Objective: Multiple treatment options are used in early local-stage cervical cancer, including combinations of surgery with neoadjuvant/adjuvant radiotherapy and chemotherapy. Our aim was to determine the outcome for definitive chemoradiation with image guided brachytherapy (IGBT). Methods: FIGO1994 staging system was used in our study. We included 123 patients with stage IB cervical cancer, treated at 12 centers with external beam radiotherapy (EBRT) ± Chemotherapy and IGBT. Three- and 5-year actuarial local control (LC), pelvic control (PC), overall survival (OS), cancer-specific survival (CSS) and late morbidity (CTCAE v 3.0) were computed. Results: Median age was 48 (23–82) years. FIGO1994 stage distribution was: IB1 68% and IB2 32%; 41% of the entire cohort had nodal metastases and 73% squamous-cell carcinoma. MRI-based tumor size was >40 mm in 63%. Median EBRT dose was 45 (40–50) Gy; 84% received chemotherapy. At IGBT, mean CTV-HR D90 was 93 ± 17 Gy (EQD210). D2cc for bladder was 76 ± 14 Gy, rectum 66 ± 11 Gy, sigmoid 66 ± 10 Gy, bowel 67 ± 7 Gy (EQD23). At 43-months median follow-up, 9% of patients had systemic, 6% paraaortic, 3% pelvic-nodal and 2% local failure. Five-year LC was 98%, PC 96%, CSS 90%, OS 83%. Intestinal G3-–4 morbidity was 8%, urinary 7% and vaginal 0%. Conclusions: Chemoradiation with IGBT for FIGO1994 stage IB cervical cancer leads to excellent loco-regional control with limited morbidity. In IB node-negative disease, it can be regarded equivalent to surgery in terms of oncologic outcome. In tumors with unfavorable pre-treatment characteristics, chemoradiation is the first choice to avoid combining surgery with adjuvant therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|