Files and links (1)
Accepted (AM)Open Access (License Unspecified), Open
Journal article
American Brachytherapy Task Group Report: A pooled analysis of clinical outcomes for high-dose-rate brachytherapy for cervical cancer
Brachytherapy, v 16(1), pp 22-43
01 Jan 2017
PMID: 28109631
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Advanced imaging used in combination with brachytherapy (BT) has revolutionized the treatment of patients with cervical cancer. We present a comprehensive review of the literature for definitive radiation with high-dose-rate (HDR) BT. In addition, we investigate potential outcome improvement with image-based brachytherapy (IBBT) compared to studies using traditional Point A dosing. This review extensively investigates acute and late toxicities.
This study reviews the literature from 2000 to 2015 with an emphasis on modern approaches including concurrent chemotherapy (chemoRT), radiation, and HDR BT and IBBT. Descriptive statistics and pelvic control (PC), disease-free survival (DFS), and overall survival (OS) outcomes were calculated using weighted means to report pooled analysis of outcomes.
Literature search yielded 16 prospective, 51 retrospective studies that reported survival outcomes, and 13 retrospective studies that focused on acute and late toxicity outcomes regardless of applicator type. There are 57 studies that report Point A dose specification with 33 having chemoRT, and 10 studies that use IBBT, 8 with chemoRT. Patients receiving radiation and chemoRT with HDR BT in the prospective studies, with >24 months followup, rates of PC were: for RT: 73%, SD: 11; CRT: 82%, SD: 8; DFS—RT: 55%, SD: 10; CRT: 65%, SD: 7; OS—RT: 66%, SD: 7; CRT: 70%, SD: 11. In the retrospective studies, the PC rates (weighted means) for the radiation and chemoradiation outcomes are 75% vs. 80%, and for DFS, the values were 55% vs. 63%, respectively. Comparing patients receiving chemoRT and IBBT to traditional Point A dose specification, there is a significant improvement in PC (p < 0.01) and DFS (p < 0.01) with IBBT. The range of genitourinary late toxicity reported for radiation was Grade 3: 1–6% and for chemoRT 2–20%. The range of late gastrointestinal toxicity for radiation was Grade 3: 4–11% and for chemoRT, 1–11%. For the late gynecologic toxicity, only 1 of the 16 prospective trials report a Grade 1–2 of 17% for radiation and 9% for chemoRT effects.
We present concise outcomes of PC, DFS, OS, and toxicity for cervical cancer patients treated with chemoradiation and HDR BT. Our data suggest an improvement in outcomes with the use of IBBT compared with traditional Point A dose prescriptions. In conclusion, HDR BT is a safe, effective modality when combined with IBBT.
Metrics
Details
- Title
- American Brachytherapy Task Group Report: A pooled analysis of clinical outcomes for high-dose-rate brachytherapy for cervical cancer
- Creators
- Jyoti Mayadev - University of California Davis Medical CenterAkila Viswanathan - Harvard UniversityYu Liu - University of California Davis Medical CenterChin-Shang Li - University of California Davis Medical CenterKevin Albuquerque - The University of Texas Southwestern Medical CenterAntonio L. Damato - Harvard UniversitySushil Beriwal - Pittsburg State UniversityBeth Erickson - Medical College of Wisconsin
- Publication Details
- Brachytherapy, v 16(1), pp 22-43
- Publisher
- Elsevier
- Grant note
- R21 167800 / NIH (http://dx.doi.org/10.13039/100000002) UL1 TR000002 / National Institutes of Health (http://dx.doi.org/10.13039/100000002) National Center for Advancing Translational Sciences (http://dx.doi.org/10.13039/100006108)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000392793900003
- Scopus ID
- 2-s2.0-85009876411
- Other Identifier
- 991021897384504721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging