Long-term results of robotic radiosurgery for non brachytherapy patients with cervical cancer
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.
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...
The purpose of this study is to explore knowledge-based organ-at-risk dose estimation for intracavitary brachytherapy planning for cervical cancer. Using established external-beam knowledge-based dose-volume histogram (DVH) estimation methods, we sought to predict bladder, rectum, and sigmoid D2cc for tandem and ovoid treatments.
Authors: Biltekin F, Gultekin M, Yilmaz MT, Yildiz F Abstract Purpose: The purpose of this study was to evaluate the dosimetric differences between two different applicators and rectal-retraction methods used in image-guided brachytherapy (IGBT) for locally advanced cervical cancer (LACC). Material and methods: Ten patients with LACC treated with definitive chemoradiotherapy and inverse optimization-based IGBT were included in this study. In each patient, at least one fraction of IGBT was performed using tandem-ovoids (TO) with vaginal gauze packing (VGP) or tandem-ring (TR) with rectal-retractor (RR). High-ris...
Authors: Crossley N, Tipton C, Meier T, Sudhoff M, Kharofa J Abstract Purpose: Magnetic resonance imaging (MRI)-guided adaptive brachytherapy is the standard of care for cervical cancer. Hybrid intracavitary/interstitial applicators for bulky tumor (high-risk clinical target volume [HR-CTV]> 30 cc) dose escalation is recommended in the EMBRACE II trial. The value of hybrid applicators for smaller HR-CTV (
Conclusions: Our findings suggest that IMRT may represent a viable alternative in delivering the boost in patients diagnosed with gynaecological cancer not amenable to ICBRT. PMID: 32010217 [PubMed]
ConclusionsClosure of VVF is a significant challenge, with an initial success rate of 20% and an overall success rate of only 25%. Seventy percent required primary or secondary urinary diversion. Vaginal surgery was utilised in the majority to try to avoid a hostile pelvis, but the surgical approach should be tailored to individual circumstances.
l L Abstract INTRODUCTION: Research in radiation-induced urinary morbidity is limited by lack of guidelines for contouring and dose assessment of the lower urinary tract. Based on literature regarding anatomy, physiology and imaging of the lower urinary tract, this study aimed to provide advice on contouring of relevant sub-structures, reference points and reference dimensions for gynaecological radiotherapy. MATERIAL AND METHODS: 210 MRIs for Image-Guided Adaptive Brachytherapy (IGABT) were analysed in 105 locally advanced cervical cancer patients treated with radio(chemo)therapy. Sub-structures (trigone, bl...
Conclusion: Optimal plans even with orthogonal radiographs may be generated by verifying the application based on the parameters mentioned in the present study and computed tomography-based plans could be utilized more effectively instead of doing automatic or manual optimization. Whereever orthogonal radiograph based or template based ICBT practices is performed this study may create a dataset to have an optimal treatment plan even without three-dimensional images.
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]