High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes
| Autor: | Maud le Guyader, Daniel Lam Cham Kee, Mathieu Gautier, Marie-Eve Chand-Fouche, Renaud Schiappa, Brice Thamphya, Jean-Michel Hannoun-Levi |
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| Rok vydání: | 2022 |
| Předmět: |
CT
computerized tomography medicine.medical_treatment Brachytherapy R895-920 NCI national cancer institute FIGO International Federation of Gynecology and Obstetrics Medical physics. Medical radiology. Nuclear medicine CTCAE common terminology criteria for adverse events EBRT external beam radiotherapy Surveillance Epidemiology and End Results NFS nodal recurrence-free survival Original Research Article IGABT image-guided adaptative brachytherapy CTV clinical target volume HR high-risk RC254-282 Cervical cancer Univariate analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens Common Terminology Criteria for Adverse Events EMBRACE image guided intensity modulated External beam radiochemotherapy and MRI based Adaptative BRAchytherapy in locally advanced CErvical cancer EQD2Gy equivalent dose at 2 Gy IMRT intensity modulated radiotherapy pts patients PFS progression-free survival HIV human immunodeficiency virus SEER surveillance epidemiology and end results LACC locally advanced cervical cancer Oncology LDR low-dose-rate RCT radio-chemotherapy ESTRO European Society for Radiotherapy and Oncology PTV planning target volume GEC groupe européen de curiethérapie High-dose-rate NA not available medicine.medical_specialty GTV gross tumor volume MFU median follow up Urology BED biologically effective dose PET positron emission tomography OS overall survival OTT overall treatment time BMI body-mass index Median follow-up LFS local recurrence-free survival SCC squamous cell cancer medicine MFS metastatic recurrence-free survival Radiology Nuclear Medicine and imaging External beam radiotherapy Progression-free survival ICRU International Commission on Radiation Units and measurements business.industry PDR pulsed-dose-rate pt patient medicine.disease OAR organs at risk HDR high-dose-rate IR intermediate-risk LQ linear quadratic BT brachytherapy Fractionation scheme business MRI magnetic resonance imaging BID twice-a-day |
| Zdroj: | Clinical and Translational Radiation Oncology, Vol 32, Iss, Pp 15-23 (2022) Clinical and Translational Radiation Oncology |
| ISSN: | 2405-6308 |
| DOI: | 10.1016/j.ctro.2021.10.005 |
| Popis: | Highlights • Brachytherapy boost is a standard of care for locally advanced cervical cancer. • High-dose-rate brachytherapy (HDR-BT) boost procedure is not standardized. • The number of implants, fractions, doses and imaging differ in literature. • Bi-fractionated HDR-BT in 1 implant is feasible with good oncological outcome. • Bi-fractionated HDR-BT dose escalation slightly increases acute toxicity. Purpose Brachytherapy (BT) boost after radio-chemotherapy (RCT) is a standard of care in the management of locally advanced cervical cancer (LACC). As there is no consensus on high-dose-rate (HDR) BT fractionation schemes, our aim was to report the oncological outcome and toxicity profile of four different schemes using twice-a-day (BID) HDR-BT. Patients and methods This was an observational, retrospective, single institution study for patients with LACC receiving a HDR-BT boost. The latter was performed with a single implant and single imaging done on day 1. The different fractionation schemes were: 7 Gy + 4x3.5 Gy (group 1); 7 Gy + 4x4.5 Gy (group 2); 3x7Gy (group 3) and 3x8Gy (group 4). Local (LFS), nodal (NFS) and metastatic (MFS) recurrence-free survival as well as progression-free survival (PFS) and overall survival (OS) were analyzed. Acute (≤6 months) and late toxicities (>6 months) were reported. Results From 2007 to 2018, 191 patients were included. Median follow-up was 57 months [45–132] and median EQD210D90CTVHR was 84, 82 and 90 Gy for groups 2, 3 and 4 respectively (dosimetric data missing for group 1). The 5-year LFS, NFS, MFS, PFS and OS were 85% [81–90], 83% [79–86], 70% [67–73], 61% [57–64] and 75% [69–78] respectively, with no significant difference between the groups. EQD210D90CTVHR |
| Databáze: | OpenAIRE |
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