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Cervical cancer brachytherapy

I Fumagalli, C Haie-Méder, C Chargari
Brachytherapy has known major improvements in recent decades. It represents an essential component of local treatment of cervix cancers. One major breakthrough was the advent of 3D imaging for image-guided brachytherapy. Doses could be prescribed to volumes. This allows better delineation and coverage of target volumes, as well as organs at risk (bladder, rectum, sigmoid) protection. Local recurrences have been consequently reduced and survival has been improved. In addition, improvement and development of new applicators have facilitated the delivery of interstitial treatments...
May 15, 2018: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Huaising C Ko, Jessie Y Huang, Jessica R Miller, Rupak K Das, Charles R Wallace, Anna-Maria A De Costa, David M Francis, Margaret R Straub, Bethany M Anderson, Kristin A Bradley
PURPOSE: To characterize image quality and feasibility of using ViewRay MRI (VR)-guided brachytherapy planning for cervical cancer. METHODS AND MATERIALS: Cervical cancer patients receiving intracavitary brachytherapy with tandem and ovoids, planned using 0.35T VR MRI at our institution, were included in this series. The high-risk clinical target volume (HR-CTV), visible gross tumor volume, bladder, sigmoid, bowel, and rectum contours for each fraction of brachytherapy were evaluated for dosimetric parameters...
May 14, 2018: Brachytherapy
Agnieszka Zolciak-Siwinska, Adam Kowalczyk, Katarzyna Sikorska, Michal Bijok, Wojciech Michalski, Ewelina Gruszczynska
PURPOSE: To compare CT- and MRI-based brachytherapy (BT) target volumes for patients with advanced cervical cancer so as to identify those who benefit most from MRI-based planning. We also studied how the natural mobility of the organ at risks (OARs) affects the given doses. METHODS AND MATERIALS: Subjects were 60 patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IB-IVA cervical cancer. The CT high-risk clinical target volume (HR-CTV) was first delineated, then the MRI HR-CTV, with volume discrepancies calculated by subtraction...
May 12, 2018: Brachytherapy
Yun-Zhi Dang, Pei Li, Jian-Ping Li, Fei Bai, Ying Zhang, Yun-Feng Mu, Wei-Wei Li, Li-Chun Wei, Mei Shi
Purpose: To report the efficacy and late side effects(LSEs) of CT-based image-guided brachytherapy for the treatment of cervical cancer. Materials: Between 2008 and 2014, 100 patients with FIGO stage IIB-IVA cervical carcinoma were analyzed. The patients received pelvic irradiation (45-50 Gy in 25 fractions) with concurrent chemotherapy, whereas the mean prescribed EBRT dose, including initial and boost doses to positive lymph nodes, ranged from 54 to 64 Gy. Afterwards, intracavitary(IC) or combined intracavitary/interstitial(IC/IS) brachytherapy was performed using a CT-based procedure with prescribed doses of 6 or 8 Gy in 3-7 fractions...
2018: Journal of Cancer
Thomas Sullivan, Joseph H Yacoub, Matthew M Harkenrider, William Small, Murat Surucu, Steven M Shea
Brachytherapy (BT), the use of a locally placed or implanted radioactive source for treatment of an adjacent tumor, is an important component in the treatment of patients with both early- and advanced-stage cervical cancer and is increasingly part of the standard treatment protocol. When it is feasible, many radiation oncologists choose to include a magnetic resonance (MR) imaging examination for planning BT treatment (ie, an MR imaging examination after placement of the applicator but before radiation dosing)...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
K S Zhang, Z Liu, T Wang, J Wang, J Su, F Shi, R H Wang, W Yuan, Y Li
Objective: To investigate the occurrence and degree of radiation-induced injury in vagina after radical radiotherapy of cervical cancer. Methods: A total of 282 cases of patients with cervical cancer were collected from November 2016 to September 2017. All of the above patients underwent radical radiotherapy from 2008 to 2017 in the First Affiliated Hospital of Xi ' an Jiaotong University. The patients' International Federation of Gynecology and Obstetrics (FIGO) staging (2009) , brachytherapy dose, whether receive synchronous chemotherapy or not, age and body mass index (BMI) for the occurrence and severity of vaginal radiation injury at different time periods were analyzed by cross-sectional survey method...
April 25, 2018: Zhonghua Fu Chan Ke za Zhi
Naoya Ishibashi, Toshiya Maebayashi, Takuya Aizawa, Masakuni Sakaguchi, Takehiro Nakao, Masahiro Okada
Brachytherapy is a standard treatment modality for locally advanced cervical cancer. In patients with uterine anomalies, the radiation dose to the target volume and the organs at risk can vary depending on the positioning of the brachytherapy tandem implant. However, there have been few reports concerning the use of brachytherapy in patients with uterine anomalies. The present study reports the case of a 55-year-old woman with locally advanced squamous cell carcinoma of the cervix and complete septate uterus...
May 2018: Oncology Letters
In Bong Ha, Bae Kwon Jeong, Ki Mun Kang, Hojin Jeong, Yun Hee Lee, Hoon Sik Choi, Jong Hak Lee, Won Jun Choi, Jeong Kyu Shin, Jin Ho Song
Background: Although intracavitary radiotherapy (ICR) is essential for the radiation therapy of cervical cancer, few institutions in Korea perform 3-dimensional (3D)-based ICR. To identify patients who would benefit from 3D-based ICR, dosimetric parameters for tumor targets and organs at risk (OARs) were compared between 2-dimensional (2D)- and 3D-based ICR. Methods: Twenty patients with locally advanced cervical cancer who underwent external beam radiation therapy (EBRT) following 3D-based ICR were retrospectively evaluated...
April 30, 2018: Journal of Korean Medical Science
Jyoti Mayadev, Amy Klapheke, Catheryn Yashar, I-Chow Hsu, Mitchell Kamrava, Arno J Mundt, Loren K Mell, John Einck, Stanley Benedict, Richard Valicenti, Rosemary Cress
PURPOSE: The treatment for locally advanced cervical cancer is external beam radiation (EBRT), concurrent chemotherapy, and brachytherapy (BT). We investigated demographic and socioeconomic factors that influence trends in BT utilization and disparities in survival. METHODS: Using the California Cancer Registry, cervical cancer patients FIGO IB2-IVA from 2004 to 2014 were identified. We collected tumor, demographic and socioeconomic (SES) factors. We used multivariable logistic regression analysis to determine predictors of use of BT...
April 27, 2018: Gynecologic Oncology
Sherry Zhao, Louise Francis, Dorin Todor, Emma C Fields
PURPOSE: Although brachytherapy increases the local control rate for cervical cancer, there has been a progressive decline in its use. Furthermore, the training among residency programs for gynecologic brachytherapy varies considerably, with some residents receiving little to no training. This trend is especially concerning given the association between poor applicator placement and decline in local control. Considering the success of proficiency-based training in other procedural specialties, we developed and implemented a proficiency-based cervical brachytherapy training curriculum for our residents...
April 25, 2018: Brachytherapy
Daisuke Ozaki, Makoto Miyazawa, Youji Habano, Motohiro Kawashima, Yoshihiko Hoshino, Takayuki Sutou
PURPOSE: Hybrid inverse treatment planning optimization (HIPO) is a new optimization tool for brachytherapy. We verified its utility using treatment plans for combined intracavitary and interstitial brachytherapy in cervical cancer. MATERIALS & METHODS: We compared the manually optimized plan and the plan optimized using HIPO. The plan using HIPO was optimized with three different methods: needle only, tandem and needle, and all applicators. The dose volume histogram (DVH) parameters such as D90 of high risk clinical target volume (HR-CTV) and D2cc of OAR (rectum, sigmoid colon and bladder) were used to evaluate each treatment plan...
2018: Nihon Hoshasen Gijutsu Gakkai Zasshi
Negin Shahid, Timothy Craig, Mary Westerland, Allison Ashworth, Michelle Ang, David D'Souza, Raxa Sankreacha, Anthony Fyles, Michael Milosevic, Iwa Kong
PURPOSE: To recognize the practice of radiotherapy for management of cervical cancer in Ontario, Canada, and to use the results of the survey to harmonize and standardize practice across the province. METHODS AND MATERIALS: An electronic survey (SurveyMonkey) was sent to all 14 provincial cancer centers by Cancer Care Ontario Gynecology Community of Practice (CoP) in 2013. The survey included 72 questions in four different categories: general/demographic, pretreatment assessment, external beam radiotherapy (EBRT), and brachytherapy (BT)...
April 19, 2018: Brachytherapy
Ozlem Guner, Sureyya Gumussoy, Nigar Celik, Aynur Saruhan, Oya Kavlak
Objective: This study was planned as a descriptive study for the purpose of examining the sexual functions of patients' who underwent a gynecological operation and received brachytherapy. Methods: The study was conducted with 118 women who attended the Radiation Oncology Unit at Ege University Medical Faculty Hospital in Izmir Province for Gynecological Oncology follow-up, who participated voluntarily and were assigned using the random sampling method. The participants were married, sexually active, had a diagnosis of gynecologic cancer, underwent an operation and received brachytherapy for four months after the operation...
January 2018: Pakistan Journal of Medical Sciences Quarterly
Ramya Rangarajan
Aim: Since anatomical and geometric variations occur with every fraction, planning, and dose optimization is necessary for every fraction of high-dose rate intracavitary brachytherapy of carcinoma cervix. In this study, we have tried to quantify the differences in doses to organs at risk (OAR) for each fraction of brachytherapy. Methods and Materials: One hundred and seventy computed tomography datasets of cervical cancer patients receiving intracavitary brachytherapy at our institution between January and April 2015 were analyzed...
January 2018: Journal of Medical Physics
Stéphanie Smet, Richard Pötter, Christine Haie-Meder, Jacob C Lindegaard, Ina Schulz-Juergenliemk, Umesh Mahantshetty, Barbara Segedin, Kjersti Bruheim, Peter Hoskin, Bhavana Rai, Fleur Huang, Rachel Cooper, Erik van Limbergen, Kari Tanderup, Kathrin Kirchheiner
OBJECTIVE: To evaluate the pattern of manifestation of fatigue, insomnia and hot flashes within the prospective, observational, multi-center EMBRACE study. METHODS: Morbidity was prospectively assessed according to CTCAE v.3 and patient-reported outcome with EORTC QLQ-C30/CX24 at baseline and regular follow-up. Analyses of crude incidence, prevalence rates and actuarial estimates were performed. RESULTS: A total of 1176 patients were analyzed with a median follow-up of 27 months...
April 4, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Megan Andrew, Yusung Kim, Timothy Ginader, Brian J Smith, Wenqing Sun, Dongxu Wang
Purpose: To quantify the reduction of relative displacement between the implanted intracavitary applicator and the patient bony anatomy, due to the use of a hover transport system during the patient transports between the imaging table and the treatment table. Material and methods: The displacement of the applicator inside the patient was measured by comparing the distance between the tip of the tandem and the pubic bone on X-ray radiography images taken before and after moving a patient to magnetic resonance/computed tomography imaging...
February 2018: Journal of Contemporary Brachytherapy
Shivani Sud, Toni Roth, Ellen Jones
Purpose: Intra-vaginal packing is used to fix the applicator and displace organs at risk (OAR) during high-dose-rate intracavitary tandem and ovoid brachytherapy (HDR-ICB). We retain the speculum from applicator placement as a dual-function bladder and rectum retractor during treatment. Our objective is to review salient techniques for OAR displacement, share our packing technique, and determine the reduction in dose to OAR and inter-fraction variability of dose to OAR, associated with speculum-based vaginal packing (SBVP) in comparison to conventional gauze packing during HDR-ICB...
February 2018: Journal of Contemporary Brachytherapy
Kris Derks, Jacco L G Steenhuijsen, Hetty A van den Berg, Saskia Houterman, Jeltsje Cnossen, Paul van Haaren, Katrien De Jaeger
Purpose: The purpose of this study was to analyze the effect of 2D conventional brachytherapy (CBT) compared to 3D MRI-guided brachytherapy (IGBT) with and without the use of interstitial needles on local control, overall survival, and toxicity in patients treated for cervical cancer with radiation or chemoradiation. Material and methods: A retrospective analysis was performed of biopsy-proven FIGO IB-IVA cervical cancer patients, treated with primary radiation or chemoradiation, followed by brachytherapy (BT) between January 1997 and July 2016...
February 2018: Journal of Contemporary Brachytherapy
Stephen J Ramey, David Asher, Deukwoo Kwon, Awad A Ahmed, Aaron H Wolfson, Raphael Yechieli, Lorraine Portelance
OBJECTIVE: Delays in time to treatment initiation (TTI) with definitive radiation therapy (RT) or chemotherapy and RT (CRT) for cervical cancer could lead to poorer outcomes. This study investigates disparities in TTI and the impact of TTI on overall survival (OS). METHODS: Adult women with non-metastatic cervical squamous cell carcinoma diagnosed between 2004 and 2014, treated with definitive RT or CRT, and reported to the National Cancer Database were included...
April 2018: Gynecologic Oncology
Pauline Castelnau-Marchand, Patricia Pautier, Catherine Genestie, Alexandra Leary, Enrica Bentivegna, Sébastien Gouy, Jean-Yves Scoazec, Philippe Morice, Christine Haie-Meder, Cyrus Chargari
OBJECTIVE: The aim of this study was to report our institutional experience of a multimodal approach for treatment of locally advanced high-grade neuroendocrine cervical cancer. METHODS AND MATERIALS: Patients with primary locally advanced neuroendocrine cervical cancer diagnosed between 2001 and 2014 were included. The scheduled treatment sequence was as follows: pelvic +/- para-aortic radiotherapy (according to tumor stage), associated with chemotherapy based on platine-derivate and etoposide regimen, followed with a brachytherapy boost, then completion surgery if there was no progression +/- consolidation etoposide chemotherapy (for a total of 5-6 cycles)...
March 27, 2018: International Journal of Gynecological Cancer
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