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Cervical cancer brachytherapy

Ronny Kalash, Scott M Glaser, Balasubramanya Rangaswamy, Zachary D Horne, Hayeon Kim, Christopher Houser, Sushil Beriwal
PURPOSE: To investigate the correlation between positron emission tomography/computed tomography (PET/CT) response and outcome in the era of magnetic resonance imaging (MRI)-based planning and to assess whether the addition of diffusion-weighted MRI (DW-MRI) could more accurately classify treatment response and prognosis. METHODS AND MATERIALS: A retrospective chart review identified 244 consecutive patients with International Federation of Gynecology and Obstetrics stage IB1-IVA cervical cancer treated with concurrent chemoradiation, including high-dose-rate image-based brachytherapy, between 2007 and 2016...
February 6, 2018: International Journal of Radiation Oncology, Biology, Physics
Elena Manea, Alexandre Escande, Sophie Bockel, Mohamed Khettab, Isabelle Dumas, Ioana Lazarescu, Ingrid Fumagalli, Philippe Morice, Eric Deutsch, Christine Haie-Meder, Cyrus Chargari
PURPOSE: To study correlations between dose-volume parameters of the whole bladder and bladder trigone and late urinary toxicity in locally advanced cervical cancer patients treated with pulsed-dose-rate brachytherapy. METHODS AND MATERIALS: Patients with locally advanced cervical cancer treated with chemoradiation therapy and pulsed-dose-rate brachytherapy from 2004 to 2015 were included. Cumulative dose-volume parameters of the whole bladder and bladder trigone were converted into 2-Gy/fraction equivalents (EQD2, with α/β = 3 Gy); these parameters, as well as clinical factors, were analyzed as predictors of toxicity in patients without local relapse...
February 13, 2018: International Journal of Radiation Oncology, Biology, Physics
Yaomei Ma, Guiling Zhao, Ji Qi, Peisong Sun, Caiyan Liu, Pengpeng Qu, Karen K L Chan
The aim of the present study was to assess the immediate and long-term results of preoperative brachytherapy and chemotherapy followed by radical surgery compared with those of standard chemoirradiation in patients with stage IB2-IIA cervical cancer. The medical records of 70 patients with stage IB2 and IIA cervical cancer who were treated between June 2006 and June 2010 were reviewed. The patients received either standard chemoirradiation (CRT) treatment (n=20) or neoadjuvant brachytherapy with one cycle of chemotherapy followed by radical hysterectomy [operation (OT) group; n=50]...
April 2018: Molecular and Clinical Oncology
Ryo Nishikawa, Kenji Yoshida, Yasuhiko Ebina, Mayumi Omoteda, Daisuke Miyawaki, Takeaki Ishihara, Yasuo Ejima, Hiroaki Akasaka, Hitoaki Satoh, Katsusuke Kyotani, Satoru Takahashi, Ryohei Sasaki
This study aimed to compare dosimetric parameters between non-optimized and optimized treatment planning (NOP and OP, respectively) of magnetic resonance imaging (MRI) -based intracavitary (IC) image-guided adaptive brachytherapy (IGABT) using the central shielding (CS) technique for cervical cancer. Fifty-three patients treated with external beam radiotherapy using CS and MRI-based IGABT with the IC approach alone were evaluated. The total high-risk clinical target volume (HR-CTV) D90 was aimed at >70 Gy equivalent dose in 2 Gy fractions (EQD2)...
March 6, 2018: Journal of Radiation Research
Yuko Harada, Shinichiro Miyazaki
Standard radiation therapy for cervical cancer consists of external beam radiation therapy followed by an intracavitary brachytherapy boost. When brachytherapy cannot be performed due to unfavorable anatomy or coexisting medical conditions, stereotactic body radiotherapy with the CyberKnife is another treatment option which is less invasive and can be performed in a shorter treatment time. We performed non-invasive therapy using the CyberKnife for five cases of urogenital cancer located in the cervix. The local tumor control was excellent with minimal toxicity...
December 29, 2017: Curēus
Roger Sun, Ines Koubaa, Elaine Johanna Limkin, Isabelle Dumas, Enrica Bentivegna, Eduardo Castanon, Sébastien Gouy, Cynthia Baratiny, Fyo Monnot, Pierre Maroun, Samy Ammari, Elise Zareski, Corinne Balleyguier, Éric Deutsch, Philippe Morice, Christine Haie-Meder, Cyrus Chargari
Objective: We report outcomes of cervical cancer patients with bladder invasion (CCBI) at diagnosis, with focus on the incidence and predictive factors of vesicovaginal fistula (VVF). Results: Seventy-one patients were identified. Twenty-one (30%) had para-aortic nodal involvement. Eight had VVF at diagnosis. With a mean follow-up time of 34.2 months (range: 1.9 months-14.8 years), among 63 patients without VVF at diagnosis, 15 (24%) developed VVF. A VVF occurred in 19% of patients without local relapses (9/48) and 40% of patients with local relapse (6/15)...
February 6, 2018: Oncotarget
Dong Hoon Suh, Miseon Kim, Kyung Hun Lee, Keun Yong Eom, Maj Kamille Kjeldsen, Mansoor Raza Mirza, Jae Weon Kim
In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer...
March 2018: Journal of Gynecologic Oncology
Janusz Skowronek
Cancer incidence and mortality depend on a number of factors, including age, socio-economic status and geographical location, and its prevalence is growing around the world. Most of cancer treatments include external beam radiotherapy or brachytherapy. Brachytherapy, a type of radiotherapy with energy from radionuclides inserted directly into the tumor, is increasingly used in cancer treatment. For cervical and skin cancers, it has become a standard therapy for more than 100 years as well as an important part of the treatment guidelines for other malignancies, including head and neck, skin, breast, and prostate cancers...
December 2017: Journal of Contemporary Brachytherapy
Ramin Jaberi, Zahra Siavashpour, Mahmoud Reza Aghamiri, Christian Kirisits, Reza Ghaderi
Purpose: Intra-fractional organs at risk (OARs) deformations can lead to dose variation during image-guided adaptive brachytherapy (IGABT). The aim of this study was to modify the final accepted brachytherapy treatment plan to dosimetrically compensate for these intra-fractional organs-applicators position variations and, at the same time, fulfilling the dosimetric criteria. Material and methods: Thirty patients with locally advanced cervical cancer, after external beam radiotherapy (EBRT) of 45-50 Gy over five to six weeks with concomitant weekly chemotherapy, and qualified for intracavitary high-dose-rate (HDR) brachytherapy with tandem-ovoid applicators were selected for this study...
December 2017: Journal of Contemporary Brachytherapy
Andres Huertas, Isabelle Dumas, Alexandre Escande, Eleonor Rivin Del Campo, Tony Felefly, Charles-Henri Canova, Anne Tailleur, Sebastien Gouy, Enrica Bentivegna, Philippe Morice, Christine Haie-Meder, Cyrus Chargari, Renaud Mazeron
PURPOSE: Primary vaginal cancer is a rare disease for which treatment has been modeled based on cervical cancer. We report our experience in the use of image-guided adaptive brachytherapy (IGABT) in this indication. METHODS AND MATERIALS: Patients treated for vaginal cancer with a combination of external beam radiation therapy and IGABT were identified through electronic search. The Groupe Européen de Curiethérapie-European Society for Radiotherapy and Oncology recommendations for cervical cancer have been extrapolated with the definition of two clinical target volumes (CTVs) corresponding to the residual disease after external beam radiation therapy (CTVBT ), assessed from clinical and imaging findings, and the so-called CTVi , comprising the CTVBT with directional margins and at least the initial disease at diagnosis...
February 6, 2018: Brachytherapy
Sophie Otter, Amanda Coates, Adrian Franklin, Melanie Cunningham, Alexandra Stewart
PURPOSE: Image-guided brachytherapy (IGBT) is an essential component of the treatment of locally advanced cervical cancer. Interstitial (IS) catheters are being increasingly used for bulkier tumors. We have retrospectively assessed the dosimetric impact of IS catheters. METHODS AND MATERIALS: All patients who received IGBT for cervical cancer between August 2014 and February 2017 were identified. Clinical and dosimetric data were collected. Patients were grouped into the intracavitary (IC) cohort or the IC and IS implant (IC/IS) cohort...
February 6, 2018: Brachytherapy
Rachel Gerber, Alexandra Rink, Jennifer Croke, Jette Borg, Akbar Beiki-Ardakani, Anthony Fyles, Michael Milosevic, Jason Xie, Harald Keller, Kathy Han
For volumes up to 2 cm3 of the bladder and possibly up to 5 cm3 of the rectum, doses computed from the whole organ were good estimates of the doses in the wall in cervix brachytherapy, and there were no significant differences between patients treated with or without interstitial needles.
February 6, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Julia Skliarenko, Marco Carlone, Kari Tanderup, Kathy Han, Akbar Beiki-Ardakani, Jette Borg, Kitty Chan, Jennifer Croke, Alexandra Rink, Anna Simeonov, Reem Ujaimi, Jason Xie, Anthony Fyles, Michael Milosevic
PURPOSE: MR-guided brachytherapy (MRgBT) with interstitial needles is associated with improved outcomes in cervical cancer patients. However, there are implementation barriers, including magnetic resonance (MR) access, practitioner familiarity/comfort, and efficiency. This study explores a graded MRgBT implementation strategy that included the adaptive use of needles, strategic use of MR imaging/planning, and team learning. METHODS AND MATERIALS: Twenty patients with cervical cancer were treated with high-dose-rate MRgBT (28 Gy in four fractions, two insertions, daily MR imaging/planning)...
January 2018: Brachytherapy
Daline Tho, Emmanuel Racine, Harry Easton, William Y Song, Luc Beaulieu
PURPOSE: Electromagnetic tracking (EMT) is a promising technology for automated catheter and applicator reconstructions in brachytherapy. In this work, a proof-of-concept is presented for reconstruction of the individua channels of a new shielded tandem (140 mm long shield) dedicated to intensity modulated brachytherapy METHODS: All six channels of a straight prototype were reconstructed using an electromagnetic (EM) system from Aurora (NDI, Ontario, Canada). The influence of the shield on the EMT system was caracterized by taking measurements at 9 differents positions with and without the shielded part of the applicator next to the probe...
February 5, 2018: Medical Physics
Ekkasit Tharavichitkul, Somvilai Chakrabandhu, Pitchayaponne Klunklin, Wimrak Onchan, Bongkot Jia-Mahasap, Somsak Wanwilairat, Damrongsak Tippanya, Rungtip Jayasvasti, Patumrat Sripan, Razvan M Galalae, Imjai Chitapanarux
OBJECTIVES: To report the intermediate-term results of trans-abdominal ultrasound (TAUS)-guided brachytherapy in cervical cancer. MATERIALS AND METHODS: Ninety-two patients with cervical cancer (stage IB-IVA, according to FIGO staging), were treated by curative radiotherapy from February 2012 to June 2015. All patients were treated with whole pelvic radiotherapy to 50 Gy in 25 fractions and central shielding after 44 Gy, in combination with TAUS-guided brachytherapy, in order to escalate the total dose (EQD2) to the minimal dose at cervical points (in EQD2 concepts) defined by TAUS, while maintaining low doses to ICRU bladder and rectal points...
March 2018: Gynecologic Oncology
Horia Vulpe, Francis Adumata Asamoah, Manjula Maganti, Verna Vanderpuye, Anthony Fyles, Joel Yarney
PURPOSE: Most women with cervical cancer in Sub-Saharan Africa present with locally advanced disease. These women require external beam radiation therapy and brachytherapy for curative treatment, but data on their outcomes remain sparse. We report data on treatment characteristics, follow-up, toxicity, and cancer outcomes in a large population of patients from the National Centre for Radiotherapy in Accra, Ghana. METHODS AND MATERIALS: The charts of patients treated from 2006 to 2011 were reviewed...
December 21, 2017: International Journal of Radiation Oncology, Biology, Physics
Sophie Espenel, Max-Adrien Garcia, Jane-Chloé Trone, Elodie Guillaume, Annabelle Harris, Amel Rehailia-Blanchard, Ming Yuan He, Sarra Ouni, Alexis Vallard, Chloé Rancoule, Majed Ben Mrad, Céline Chaleur, Guy De Laroche, Jean-Baptiste Guy, Pablo Moreno-Acosta, Nicolas Magné
BACKGROUND: Despite screening campaigns, cervical cancers remain among the most prevalent malignancies and carry significant mortality, especially in developing countries. Most studies report outcomes of patients receiving the usual standard of care. It is possible that these selected patients may not correctly represent patients in a real-world setting, which may be a limitation in interpreting outcomes. This study was undertaken to identify prognostic factors, management strategies and outcomes of locally advanced cervical cancers (LACC) treated in daily clinical practice...
February 2, 2018: Radiation Oncology
Kota Abe, Noriyuki Kadoya, Shinya Sato, Shimpei Hashimoto, Yujiro Nakajima, Yuya Miyasaka, Kengo Ito, Rei Umezawa, Takaya Yamamoto, Noriyoshi Takahashi, Ken Takeda, Keiichi Jingu
We evaluated the impact of model-based dose calculation algorithms (MBDCAs) on high-dose-rate brachytherapy (HDR-BT) treatment planning for patients with cervical cancer. Seven patients with cervical cancer treated using HDR-BT were studied. Tandem and ovoid applicators were used in four patients, a vaginal cylinder in one, and interstitial needles in the remaining two patients. MBDCAs were applied to the Advanced Collapsed cone Engine (ACE; Elekta, Stockholm, Sweden). All plans, which were originally calculated using TG-43, were re-calculated using both ACE and Monte Carlo (MC) simulations...
January 25, 2018: Journal of Radiation Research
Simona Cima, Anna Myriam Perrone, Paolo Castellucci, Gabriella Macchia, Milly Buwenge, Silvia Cammelli, Savino Cilla, Martina Ferioli, Gabriella Ferrandina, Andrea Galuppi, Eugenio Salizzoni, Daniela Rubino, Stefano Fanti, Pierandrea De Iaco, Alessio Giuseppe Morganti
OBJECTIVE: The aim of this study was to investigate the impact of SUVmax fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) measured in the primary tumor, pelvic and para-aortic node with disease-free survival (DFS) and overall survival (OS) in patients with locally advanced cervical cancer. METHODS AND MATERIALS: A total of 92 patients with histological diagnosis of locally advanced cervical cancer are treated with radiochemotherapy plus brachytherapy boost from January 2008 to April 2014 in our Institution...
January 24, 2018: International Journal of Gynecological Cancer
Edgar Gelover, Cabel Katherine, Christopher Mart, Wenqing Sun, Yusung Kim
The objective of this study was to assess the recommended DVH parameter (e.g., D2 cc) addition method used for combining EBRT and HDR plans, against a reference dataset generated from an EQD2-based DVH addition method. A revised DVH parameter addition method using EBRT DVH parameters derived from each patient's plan was proposed and also compared with the reference dataset. Thirty-one biopsy-proven cervical cancer patients who received EBRT and HDR brachytherapy were retrospectively analyzed. A parametrial and/or paraaortic EBRT boost were clinically performed on 13 patients...
January 19, 2018: Journal of Applied Clinical Medical Physics
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