Hybrid (CT/MRI based) vs. MRI only based image-guided brachytherapy in cervical cancer: Dosimetry comparisons and clinical outcome

Choong, Ee Siang; Bownes, Peter; Musunuru, Hima Bindu; Rodda, S.; Richardson, C; Al-Qaisieh, B.; Swift, S.; Orton, Jane; Cooper, R.

doi:10.1016/j.brachy.2015.09.002

Cited by 33 publications

(24 citation statements)

References 22 publications

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“…However, such overestimations may be improved by including information from 3D documentation of physical examinations and diagnostic MRI without applicator insertion before brachytherapy [ 32 , 33 ]. Moreover, a combination of MRI-based 3D IGBT for the first session and CT-based 3D IGBT for the subsequent sessions has yielded excellent LC and OS rates [ 34 ]. In the present study, CT-based 3D IGBT was performed, which was supported by gynecological examinations, ultrasound guidance, and MRI at diagnosis and within 1 week before the first session of brachytherapy.…”

Section: Discussionmentioning

confidence: 99%

In-room computed tomography–based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study

Ohno

Noda

Okonogi

et al. 2016

Journal of Radiation Research

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Herein, we investigate the long-term clinical outcomes for cervical cancer patients treated with in-room computed tomography–based brachytherapy. Eighty patients with Stage IB1–IVA cervical cancer, who had undergone treatment with combined 3D high-dose rate brachytherapy and conformal radiotherapy between October 2008 and May 2011, were retrospectively analyzed. External beam radiotherapy (50 Gy) with central shielding after 20–40 Gy was performed for each patient. Cisplatin-based chemotherapy was administered concurrently to advanced-stage patients aged ≤75 years. Brachytherapy was delivered in four fractions of 6 Gy per week. In-room computed tomography imaging with applicator insertion was performed for treatment planning. Information from physical examinations at diagnosis, and brachytherapy and magnetic resonance imaging at diagnosis and just before the first brachytherapy session, were referred to for contouring of the high-risk clinical target volume. The median follow-up duration was 60 months. The 5-year local control, pelvic progression-free survival and overall survival rates were 94%, 90% and 86%, respectively. No significant differences in 5-year local control rates were observed between Stage I, Stage II and Stage III–IVA patients. Conversely, a significant difference in the 5-year overall survival rate was observed between Stage II and III–IVA patients (97% vs 72%; P = 0.006). One patient developed Grade 3 late bladder toxicity. No other Grade 3 or higher late toxicities were reported in the rectum or bladder. In conclusion, excellent local control rates were achieved with minimal late toxicities in the rectum or bladder, irrespective of clinical stage.

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Section: Discussionmentioning

confidence: 99%

In-room computed tomography–based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study

Ohno

Noda

Okonogi

et al. 2016

Journal of Radiation Research

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“…Choong et al . [38] have reported results comparing this hybrid technique with IGBT planning based on MRI at each fraction, and showed that the 3-year local control and survival rates were similar. The dosimetry achieved and late toxicity were also similar between the two groups.…”

Section: Imaging – Mri/us/ctmentioning

confidence: 99%

Improving the efficiency of image guided brachytherapy in cervical cancer

Otter¹,

Franklin²,

Ajaz³

et al. 2016

jcb

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Brachytherapy is an essential component of the treatment of locally advanced cervical cancers. It enables the dose to the tumor to be boosted whilst allowing relative sparing of the normal tissues. Traditionally, cervical brachytherapy was prescribed to point A but since the GEC-ESTRO guidelines were published in 2005, there has been a move towards prescribing the dose to a 3D volume. Image guided brachytherapy has been shown to reduce local recurrence, and improve survival and is optimally predicated on magnetic resonance imaging. Radiological studies, patient workflow, operative parameters, and intensive therapy planning can represent a challenge to clinical resources. This article explores the ways, in which 3D conformal brachytherapy can be implemented and draws findings from recent literature and a well-developed hospital practice in order to suggest ways to improve the efficiency and efficacy of a brachytherapy service. Finally, we discuss relatively underexploited translational research opportunities.

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“…Statistically, cervical cancer accounts for most of women cancers [1, 2]. In spite of current progressions in the diagnosis and treatment including operation intervention, chemo-/radiotherapy, the five years overall survival status remains about fifty percent because the diagnosis of most of cervical cancer patients are defined at a advanced stage, and patients had lymphatic metastasis of cervical cancer [3, 4]. Increasing evidence have demonstrated that many signaling pathways affected the development of cervical cancer, among the imbalance between oncogenes and tumor suppressor genes is responsible for the development of tumors [5], however the specific molecular mechanism of cervical cancer is not yet fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

MiR-142 inhibits the development of cervical cancer by targeting HMGB1

Jiang

Wang

et al. 2016

Oncotarget

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It has been reported that miRNAs is deregulated in diverse human cancers, involving human cervical cancer. However, the clinical significances and potential mechanisms of miR-142 in the development and progression of cervical cancer were not elucidated completely till now. In this study, we found that the expression of miR- 142 was obviously down-regulated in human cervical cancer tissues and a panel of cell lines. According to statistics, the expression of miR-142 was negatively related to advanced FIGO stage and lymphatic metastasis (p < 0.001). Furthermore, our functional analysis revealed the overexpression of miR-142 affected cell proliferation and invasiveness, and enhanced cell apoptosis in representative SiHa and HeLa cells. Based on the molecular level, our findings showed the 3′ untranslated region (3′-UTR) of high-mobility group box 1 protein (HMGB1) was a direct target of miR-142, and determined an inverse correlation with the expression of miR-142. Ectopic expression of HMGB1 could attenuate the inhibitory impact of miR-142 on the proliferation and invasiveness of cervical cancer cells. In conclusion, the present work suggested that miR-142 affects cervical cancer cell proliferation and invasiveness, and enhances cell apoptosis via directly targeting the expression of HMGB1, and these findings may lay a novel foundation for the promising therapy target of cervical cancer.

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Hybrid (CT/MRI based) vs. MRI only based image-guided brachytherapy in cervical cancer: Dosimetry comparisons and clinical outcome

Cited by 33 publications

References 22 publications

In-room computed tomography–based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study

In-room computed tomography–based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study

Improving the efficiency of image guided brachytherapy in cervical cancer

MiR-142 inhibits the development of cervical cancer by targeting HMGB1

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