Monte Carlo dosimetry study of novel rotating MRI-compatible shielded tandems for intensity modulated cervix brachytherapy
The standard of care for women with unresectable cervical cancer includes external beam radiotherapy (EBRT) with chemotherapy followed by a brachytherapy (BT) boost . EBRT which treats the pelvis and adjacent nodal regions provides approximately 50% of the total dose. BT provides the remaining course of radiation to destroy the residual tumor cells. Recent advances in magnetic resonance image (MRI) guided BT have significantly improved local control: 95 –100% in limited stages (FIGO IB-IIB) and 85–90% in more advanced stages .
In the treatment of locally advanced cervical cancer (LACC) patients, the current treatment of choice is the administration of external beam radiotherapy (EBRT) with concomitant chemotherapy and image-guided adaptive brachytherapy. Research has shown that this patient group suffers from a variety of side effects caused by the treatment. Patients report, among others, gastrointestinal (GI) toxicity, genitourinary (GU) toxicity and overall decrease in quality of life (QoL) in both the acute and late phase after treatment .
CONCLUSIONS: HT boost treatment showed comparable disease outcomes with those observed with conventional BT in patients with advanced cervical cancer. HT could be a complementary boost protocol as a single modality or hybrid with BT in selected patients. Further studies with longer follow-up periods are warranted to confirm long-term outcomes. PMID: 32026658 [PubMed - as supplied by publisher]
AbstractThe role of adjuvant chemotherapy (CT) is controversial in endometrial carcinoma (EC). Surgery alone is usually curative for women who are at a low risk of disease recurrence. The treatment of EC following surgical staging is based on the risk of relapse, which is defined by the cancer stage at diagnosis, histology of the tumor and other prognostic factors such as grade differentiation, the presence of substantial lymphovascular invasion (LVSI), or depth of myometrial invasion (MI). External beam radiotherapy (EBRT) and/or vaginal brachytherapy (VBT) improved local control and are used as adjuvant treatment for ear...
Conclusion: The study did not demonstrate a significant benefit in administering resistant starch over and above normal diet to patients receiving pelvic radiotherapy. The reasons may be attributed to concurrent use of chemotherapy and decrease in intestinal probiotics. The use of digestible starch in the control arm may have contributed to lower incidence of the toxicity endpoints as well.
Primary vaginal cancer is a rare gynaecologic cancer, constituting approximately 3% of gynaecological malignancies . Radiotherapy including brachytherapy is the treatment of choice for the majority of patients as organ-sparing surgery with negative resection margins is difficult to achieve . Due to its rarity, the treatment strategy for primary vaginal cancer is based on experience from the treatment of locally advanced cervical cancer with which it shares many similarities. Therefore, a combination of external beam radiotherapy (EBRT) (45 –50 Gy with 1.8–2 Gy per fraction) and a brachytherapy-b...
Conclusion: The addition of BB to standard CRT improved OS for women with cervical cancer and a positive margin after hysterectomy. No consistent survival benefit was seen to EBRT dose-escalation beyond 5040 cGy.
CONCLUSIONS: This is a rare heterochronous metastatic presentation of cervical cancer without loco-regional recurrence and visceral organs such as the lung, liver, and brain. The optimal treatment remains undefined for these patients. Multimodality treatment is necessary to manage the patients. PMID: 32372163 [PubMed - in process]
CONCLUSION: IMRT is a highly conformal technique. Satisfactory target volume coverage was achieved with both techniques, with better sparing of OARs in the IMRT group. With this technique improvement, we expect better quality of life in cervical cancer patients with good prognosis. PMID: 31786871 [PubMed - in process]
Conclusions: ICBT treatment with 9 Gy in two fractions offers equivocal local control rates and survival rates in cancer cervix cases with many advantages of short overall treatment time, improved patient compliance, cost effectiveness, and reduced exposure to aesthetic agents. The toxicities observed were few, low grade, and easily manageable. PMID: 31749851 [PubMed]
CONCLUSIONS: Chemo-brachytherapy is associated with higher acute toxicity with comparable response rates. Small patient numbers and short follow up impedes us from providing conclusive evidence. PMID: 31554360 [PubMed - in process]