Pre-plan technique feasibility in multi-interstitial/endocavitary perineal gynecological brachytherapy.
Conclusions: We describe a virtual pre-planning technique using a multi-interstitial and endocavitary perineal template. It is based on a virtual work with MRI images. This procedure has shown to be feasible and efficient in clinical practice by facilitating the work of specialists, and reducing uncertainties of the application. PMID: 29204168 [PubMed]
The standard of care for locally advanced cervical cancer is the combination of chemotherapy, external beam radiation therapy (EBRT), and brachytherapy. The integration of magnetic resonance imaging –based planning and delivery for brachytherapy has resulted in local control rates of 80-90%, with a reduced risk of grade 3 morbidities (1). Despite these excellent results, a surprising number of patients with cervical cancer do not receive brachytherapy in favor of intensity modulated radiation therapy (IMRT) or stereotactic body radiation therapy boosts, resulting in inferior survival outcomes (2, 3).
Conclusions: MRI-based IGBT remains the gold standard. CT planning may compromise HRCTVmriD90 or increase OARmriD2cc, which could decrease local control or increase treatment toxicity. PMID: 29204165 [PubMed]
International brachytherapy consortiums are advocating for the incorporation of magnetic resonance imaging (MRI) into the cervical brachytherapy process as a standard-of-care. Although some evaluations have been performed to quantify the effect on procedural time, little is known about the views and experiences of key stakeholders during the transition from computed tomography to MR-guided brachytherapy. This qualitative research project explored insights from key stakeholders related to a change in the gynaecologic brachytherapy process.
CONCLUSIONS: The incidence rate of PIF among patients who received RT for locally advanced cervical cancer was 15.8%. The principal predisposing factors for post-radiation PIF were postmenopausal state, rheumatoid arthritis, and HDR-ICBT use. Active interventions, including bone density screening followed by medication, should be considered during the early stage of RT for women with high-risk factors of PIF. PMID: 29055558 [PubMed - as supplied by publisher]
BackgroundRobust approaches to quantify tumor heterogeneity are needed to provide early decision support for precise individualized therapy. PurposeTo conduct a technical exploration of longitudinal changes in tumor heterogeneity patterns on dynamic contrast‐enhanced (DCE) magnetic resonance imaging (MRI), diffusion‐weighted imaging (DWI) and FDG positron emission tomography / computed tomography (PET/CT), and their association to radiation therapy (RT) response in cervical cancer. Study TypeProspective observational study with longitudinal MRI and PET/CT pre‐RT, early‐RT (2 weeks), and mid‐RT (5 weeks). Populati...
CONCLUSION: Since complete remission at 3 months is predictive for favourable long-term nodal control, our study indicates that CovP for SIB is promising. PMID: 28849684 [PubMed - as supplied by publisher]
CONCLUSIONS: Previous publications have supported a transition to MRI-based brachytherapy, and this can be safely and efficiently accomplished as described in this manuscript. PMID: 28533808 [PubMed - in process]
CONCLUSIONS: Three-dimensional reconstructed trans-applicator intracavitary ultrasonographic images clearly depicted meat tissue within the phantom, and could thus be used for brachytherapy planning. This study proves the concept of trans-applicator intracavitary ultrasonography for intracavitary brachytherapy. Further research such as development of intracavitary ultrasonography system, 3D reconstruction method, ultrasonography-compatible applicators, and ultrasonography-based target concept is warranted to assess the potential clinical application. PMID: 28533804 [PubMed - in process]
Brachytherapy is an integral component in the curative management of cervical cancer. Recent studies have demonstrated the most favorable outcomes with magnetic resonance imaging- (MRI) based brachytherapy and a combined intracavitary/interstitial (IC/IS) applicator. The aim of this study is to report early outcomes and determine how doses to the target and organs at risk (OAR) change over time especially after incorporation of an IC/IS applicator in a new MRI-based cervical brachytherapy program.
To evaluate if the addition of 3D transabdominal ultrasound (3DTAUS) imaging to computed tomography (CT) can improve treatment planning in 3D adaptive brachytherapy when compared with CT-based planning alone, resulting in treatment plans closer to the ones obtained using magnetic resonance imaging (MRI)-based planning.