Can stereotactic body radiotherapy replace brachytherapy for locally advanced cervical cancer? French society for radiation oncology statement.

[Can stereotactic body radiotherapy replace brachytherapy for locally advanced cervical cancer? French society for radiation oncology statement]. Cancer Radiother. 2020 Aug 01;: Authors: Chargari C, Renard S, Espenel S, Escande A, Buchheit I, Ducassou A, Peiffert D, Hannoun-Lévi JM Abstract Brachytherapy is part of the treatment of locally advanced cervical cancers, accounting for about half of the total delivered dose. The benefit of dose escalation is the most important in advanced cases or if the tumor has responded poorly. The use of interstitial implantations makes it possible to reach doses of the order of 85 to 90Gy (including external beam radiotherapy contribution) in most patients, through image-guided approaches. Brachytherapy delivery is one of the quality criteria for patient care. To date, no data allow us to consider as an alternative the use of external boost through intensity-modulated or stereotactic body radiotherapy. Indeed, the doses delivered to the tumor and the capacity to spare normal tissues remains lower, as compared to what is permitted by brachytherapy. It is therefore appropriate for centers that do not have access to the technique to establish networks with centers where brachytherapy is performed, to allow each patient to have access to the technique. It is also necessary to promote brachytherapy teaching. The issue of reimbursement will be crucial in the coming years to maintain expertise that is today insufficient...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research

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High dose-rate (HDR) brachytherapy (BT) is commonly used to treat prostate and cervical cancer by irradiating the target volume using dedicated applicators and/or catheters. BT offers sharp dose gradients which may lead to decreased dose to organs at risk compared to external beam radiotherapy.[1,2] Image-guided implant reconstruction has become standard practice, using medical imaging such as CT, MR or ultrasound acquired before treatment planning.[3,4] After reconstructing the applicator and/or interstitial catheters, a treatment plan is created using the target and organ at risk delineations by optimizing dwell times in...
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original Article Source Type: research
ConclusionBrachytherapy remains the standard of care for patients diagnosed with cervical cancer and indication for primary chemoradiation. In terms of local control, CyberKnife ®-based boost concepts provide excellent local control. It can be an alternative for patients who cannot receive adequate brachytherapy. Distant relapse still remains a challenge in this context.
Source: Strahlentherapie und Onkologie - Category: Cancer & Oncology Source Type: research
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.
Source: Brachytherapy - Category: Cancer & Oncology Authors: Source Type: research
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.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Source Type: research
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
Source: Journal of Medical Imaging and Radiation Sciences - Category: Radiology Authors: Source Type: research
Authors: Lombe D, Phiri M, Msadabwe S Abstract International travel has largely been suspended due to the COVID-19 pandemic. Due to this situation, Zambia has not been able to import radioactive isotopes for High Dose Rate (HDR) brachytherapy, Iridium 192 (I192) and this has led to suspension of treatment for patients. Cancer of the cervix is the most common cancer in Zambia and brachytherapy is a core component of the treatment armamentarium. Mitigation strategies may include external beam radiotherapy boost or hysterectomy but both systems are overburdened and fragile. PMID: 32728388 [PubMed]
Source: Ecancermedicalscience - Category: Cancer & Oncology Tags: Ecancermedicalscience Source Type: research
Abstract BACKGROUND: Early prediction of response to concurrent chemoradiotherapy (cCRT) could aid to further optimize treatment regimens for locally advanced cervical cancer (LACC) in the future. PURPOSE: To explore whether quantitative parameters from baseline (pre-therapy) magnetic resonance imaging (MRI) and FDG-PET/computed tomography (CT) have potential as predictors of early response to cCRT. MATERIAL AND METHODS: Forty-six patients with LACC undergoing cCRT after staging with FDG-PET/CT and MRI were retrospectively analyzed. Primary tumor volumes were delineated on FDG-PET/CT, T2-weighted (T2W)-M...
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research
Authors: Zhao Z, Zhang N, Liu Y, Wu N, Mao Z, Yang W, Cheng G Abstract Purpose: To analyze the results of clinical utilization of ring applicator for combined intracavitary (IC)/interstitial (IS) image-guided brachytherapy (BT) technique in locally advanced cervical cancer (LACC), and to explore the application conditions of IC/IS BT approach with this applicator for Chinese patients. Material and methods: IC/IS BT was performed in total of 95 LACC patients, who already received external beam radiotherapy. In forty-three of these patients, utilization of ring applicator in brachytherapy was done, including IC/I...
Source: Journal of Contemporary Brachytherapy - Category: Cancer & Oncology Tags: J Contemp Brachytherapy Source Type: research
Conclusions: Unlike past results, gemcitabine and cisplatin appear to be tolerable, efficient and feasible when combined with conformal radiotherapy.
Source: Journal of Cancer - Category: Cancer & Oncology Authors: Tags: Research Paper Source Type: research
Shueng The aim was to compare the clinical outcomes and prognostic factors of cervical cancer between elderly and younger women, and to explore which treatment strategy is more appropriate for elderly patients. We retrospectively reviewed patients with cervical cancer receiving definitive radiotherapy (RT) between 2007 and 2016, and divided them into two age groups: age < 70 vs. age ≥ 70. The clinical outcomes were compared between the two age groups. The median follow-up was 32.2 months. A total of 123 patients were eligible, 83 patients in group 1 (age < 70), and 40 patients in group 2 (age &...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
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