Journal article
Three-dimensional High Dose Rate Intracavitary Image-guided Brachytherapy for the Treatment of Cervical Cancer Using a Hybrid Magnetic Resonance Imaging/Computed Tomography Approach: Feasibility and Early Results
Clinical oncology (Royal College of Radiologists (Great Britain)), v 23(10), pp 685-690
01 Dec 2011
PMID: 21908180
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To evaluate the feasibility and outcome of image-guided brachytherapy (IGBT) for treating cervical cancer using magnetic resonance imaging (MRI)-based planning for the first fraction followed by computed tomography (CT)-based planning for subsequent fractions.
Forty-four patients with cervical cancer were treated with three-dimensional high dose rate IGBT. The brachytherapy dose was 5.0–6.0
Gy
×
five fractions. All but five patients received concurrent weekly cisplatinum at 40
mg/m
2. All patients received external beam radiotherapy (EBRT) with a median dose of 45
Gy over 25 fractions. Total doses for the high-risk clinical target volume (HRCTV) and organs at risk, including the rectum, bladder and sigmoid, from EBRT and brachytherapy were summated and normalised to a biologically equivalent dose of 2
Gy per fraction (EQD
2). At 3 months after therapy, any early response was assessed with positron emission tomography (PET)/CT imaging.
The mean
D
90 for the HRCTV was 83.3 (3.0) Gy. The mean 2
cm
3 dose to the bladder, rectum and sigmoid colon organs was 79.7 (5.1), 57.5 (4.4) and 66.8 (5.7) Gy, respectively. All but one (2.3%) patient had a complete response. Follow-up PET/CT was carried out in 41 (93.0%) patients, of whom 38 (92.5%) had a complete response. Of the 38 patients with a complete response on PET/CT, two had local recurrences at 6 and 8 months, respectively. Actuarial 2 year local control, disease-specific and overall survival rates were 88, 85 and 86%, respectively.
This is the first report of three-dimensional high dose rate IGBT for the treatment of cervical cancer using a hybrid MRI/CT approach. Early results have shown the feasibility of this approach with excellent local control. Additional studies are needed to assess long-term outcomes of local control and associated morbidities.
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Details
- Title
- Three-dimensional High Dose Rate Intracavitary Image-guided Brachytherapy for the Treatment of Cervical Cancer Using a Hybrid Magnetic Resonance Imaging/Computed Tomography Approach: Feasibility and Early Results
- Creators
- S. Beriwal - UPMC Hillman Cancer CenterN. Kannan - UPMC Hillman Cancer CenterH. Kim - UPMC Hillman Cancer CenterC. Houser - UPMC Hillman Cancer CenterR. Mogus - UPMC Hillman Cancer CenterP. Sukumvanich - Magee-Womens HospitalA. Olawaiye - Magee-Womens HospitalS. Richard - Magee-Womens HospitalJ.L. Kelley - Magee-Womens HospitalR.P. Edwards - Magee-Womens HospitalT.C. Krivak - Magee-Womens Hospital
- Publication Details
- Clinical oncology (Royal College of Radiologists (Great Britain)), v 23(10), pp 685-690
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000297495400006
- Scopus ID
- 2-s2.0-80055116114
- Other Identifier
- 991021897290304721
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- Web of Science research areas
- Oncology