Clinical outcomes of definitive chemoradiation followed by intracavitary pulsed-dose rate image-guided adaptive brachytherapy in locally advanced cervical cancer

Castelnau-Marchand, P.; Chargari, Cyrus; Maroun, Pierre; Dumas, Isabelle; Campo, Eleonor Rivin del; Cao, Kim; Petit, Claire; Martinetti, F.; Tafo-Guemnie, Alain; Lefkopoulos, Dimitri; Morice, Philippe; Haie-Méder, Christine; Mazeron, R.

doi:10.1016/j.ygyno.2015.09.008

Cited by 100 publications

(78 citation statements)

References 30 publications

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“…More details on the dosimetric process are provided in previous publications. 13,16,17 Contrary to the strategy used for other histological types, a completion hysterectomy was systematically scheduled 6 to 8 weeks after BT in patients who had no tumor progression at MRI or PET/CT and who were potentially amenable to complete surgery with negative margins. This rationale of systematic surgery was based on the postulate that radiosensitivity is lower in NECC than that of squamous cell carcinoma.…”

Section: Multimodal Management Schedulementioning

confidence: 99%

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Castelnau-Marchand¹,

Pautier²,

Genestie³

et al. 2018

Int J Gynecol Cancer

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Section: Multimodal Management Schedulementioning

confidence: 99%

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Castelnau-Marchand¹,

Pautier²,

Genestie³

et al. 2018

Int J Gynecol Cancer

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“…There are an increasing number of published reports regarding treatment results of IGABT for cervical cancer as shown in Table 4 [8][9][10][11][12][14][15][16][17]. In 2011, Pötter et al retrospectively analyzed 156 patients with FIGO stage IB to IVA cervical cancer treated by IGABT at Medical University of Vienna [8].…”

Section: Reported Treatment Resultsmentioning

confidence: 99%

Image‐Guided Adaptive Brachytherapy for Cervical Cancer Using Magnetic Resonance Imaging: Overview and Experience

Yoshida¹,

Nishikawa²,

Miyawaki³

et al. 2017

Radiotherapy

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Image-guided adaptive brachytherapy (IGABT) using magnetic resonance imaging (MRI) has been accepted as a novel treatment technique for cervical cancer. During the development of MRI-based IGABT, a very important concept called "High-risk clinical target volume (HR-CTV)" was introduced. However, computed tomography (CT)-based IGABT is the most common modality in Japan.MRI-based IGABT was initiated in September 2014 at Kobe University Hospital and 50 patients were treated through March 2016. Although a total HR-CTV D90 ranging from 80 to 85 Gy equivalent dose in 2 Gy fractions in combination with 45 Gy of external beam radiotherapy (EBRT) and 7 Gy×4 fractions of IGABT is the most standard treatment aim in European institutions, our aim for a total HR-CTV D90 was a 70-80 Gy because of the use of the central shielding technique for the protection of organs at risk in the late phase of EBRT.The mean total HR-CTV D90 for our 50 patients was 77 Gy. Although our aim was achieved, it was relatively low because Japanese radiotherapy protocols for cervical cancer still differ from those in European institutions. Therefore, a new treatment protocol, which is closer to the global standard, should be established.

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“…38-41 Excellent clinical results of mono-and multi-institutional studies can be regarded as indirect confirmation of validity of the concepts and terms, defined in these recommendations. 9-16 While guidelines for CT-based contouring recently became available, physical limitations of CT for soft tissue depiction remain a major impediment 50 . Not surprisingly, inter-observer studies on contouring variation demonstrate superior results for MRI-based delineation when compared with CT-based approach.…”

Section: Discussionmentioning

confidence: 99%

“…Dosimetric advantages of IGABT over conventional 2D BT are well documented and are reflected in superior clinical outcomes. 7-16 …”

Section: Introductionmentioning

confidence: 99%

Virtual modelling of novel applicator prototypes for cervical cancer brachytherapy

Petrič

Hudej

Al-Hammadi

et al. 2016

Radiology and Oncology

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BackgroundStandard applicators for cervical cancer Brachytherapy (BT) do not always achieve acceptable balance between target volume and normal tissue irradiation. We aimed to develop an innovative method of Target-volume Density Mapping (TDM) for modelling of novel applicator prototypes with optimal coverage characteristics. Patients and methods. Development of Contour-Analysis Tool 2 (CAT-2) software for TDM generation was the core priority of our task group. Main requests regarding software functionalities were formulated and guided the coding process. Software validation and accuracy check was performed using phantom objects. Concepts and terms for standardized workflow of TDM post-processing and applicator development were introduced.ResultsCAT-2 enables applicator-based co-registration of Digital Imaging and Communications in Medicine (DICOM) structures from a sample of cases, generating a TDM with pooled contours in applicator-eye-view. Each TDM voxel is assigned a value, corresponding to the number of target contours encompassing that voxel. Values are converted to grey levels and transformed to DICOM image, which is transported to the treatment planning system. Iso-density contours (IDC) are generated as lines, connecting voxels with same grey levels. Residual Volume at Risk (RVR) is created for each IDC as potential volume that could contain organs at risk. Finally, standard and prototype applicators are applied on the TDM and virtual dose planning is performed. Dose volume histogram (DVH) parameters are recorded for individual IDC and RVR delineations and characteristic curves generated. Optimal applicator configuration is determined in an iterative manner based on comparison of characteristic curves, virtual implant complexities and isodose distributions.ConclusionsUsing the TDM approach, virtual applicator prototypes capable of conformal coverage of any target volume, can be modelled. Further systematic assessment, including studies on clinical feasibility, safety and effectiveness are needed before routine use of novel prototypes can be considered.

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Clinical outcomes of definitive chemoradiation followed by intracavitary pulsed-dose rate image-guided adaptive brachytherapy in locally advanced cervical cancer

Cited by 100 publications

References 30 publications

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Image‐Guided Adaptive Brachytherapy for Cervical Cancer Using Magnetic Resonance Imaging: Overview and Experience

Virtual modelling of novel applicator prototypes for cervical cancer brachytherapy

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