Single Application Brachytherapy in Cervical Cancer
Condition: Cervical Cancer Intervention: Radiation: Single application multi-fraction brachytherapy Sponsor: Tata Memorial Hospital Not yet recruiting - verified April 2017
India has a longstanding tradition in the practice of brachytherapy and has actively contributed to the scientific literature by conducting prospective studies, clinical audits, developing innovative techniques, and performing randomized studies. Indian investigators have also contributed to international collaborative research, education, training programs along with guideline development for brachytherapy in cervix and head and neck cancers. The present article summarizes the key contributions to scientific literature, current infrastructure, skill set for brachytherapy, existing challenges, and strategy to further stren...
Brachytherapy (BT) is an essential component of definitive therapy for locally advanced cervical cancer. Despite the advantages of the dose distribution with BT in cervical cancer, there is paucity of specific skills required for good-quality BT applications. Furthermore, replacing BT with other modern external beam techniques as a boost can lead to suboptimal results in cervix cancer.
In this study, we investigate the role of diffusion-weighted imaging –derived apparent diffusion coefficient (ADC) maps to aid in IGABT.
Cervical brachytherapy (BT) is a critical component in the definitive treatment for patients with cervical cancer. Current American Brachytherapy Society and GEC-ESTRO Working group guidelines recommend a 3D treatment planning approach for cervical brachytherapy1-3. Tumor delineation using magnetic resonance imaging (MRI) is superior to CT-guided contouring, resulting in improved local control, cancer specific survival, and overall survival4. Unfortunately, the logistics and cost of obtaining post implantation MRI is impractical for most Radiation Oncology Departments.
In patients with locally advanced cervical and endometrial cancer treated with combination chemotherapy, external beam radiation (EBRT) and brachytherapy, ureteral strictures are a rare though potentially severe toxicity. Dosimetric constraints have yet to be defined for these adjacent organs at risk.
Following hysterectomy for endometrial and cervical cancer, recurrence is common in the vaginal cuff. The American Brachytherapy Society recommends prescribing to an active length (AL) of 3-5 cm (AL) with vaginal cuff brachytherapy (VCB) following hysterectomy (Gaffney D, et al. Brachytherapy 2012). The most common fixed and fractional length prescriptions in endometrial cancer are 4 cm or the proximal half of the vagina, respectively (Small W Jr, et al. Brachytherapy 2016). Length of vagina irradiation is associated with toxicity (Smeds AC et al.
As the utilization of brachytherapy procedures continues to decline in clinics, a need for accessible training tools is required to help bridge the gap between resident comfort in brachytherapy training and clinical practice. To improve the quality of intracavitary and interstitial high-dose-rate brachytherapy education, a multimaterial, modular, three-dimensionally printed pelvic phantom prototype simulating normal and cervical pathological conditions has been developed.
Regular audits are a key component to a quality radiation treatment program. In an effort to understand current practice and plan for future state we performed an outcomes audit of our locally advanced cervix cancer patients treated with concurrent chemotherapy, external beam radiation therapy and brachytherapy. Our objective was to determine treatment outcomes and late toxicity
This report describes persistence of late substantial treatment-related patient-reported symptoms (LAPERS) in the multi-institutional XXX study on MR image-guided adaptive brachytherapy in locally advanced cervical cancer (LACC).
CONCLUSION: This score includes three biomarkers with easily remembered cut-offs that allow us to identify, at the time of diagnosis, those patients with a high risk of relapse (scores of two or three) and those requiring dose escalation. PMID: 32828580 [PubMed - as supplied by publisher]