Reducing dose to rectum by placement of a rectum-emptying tube in cervical cancer patients treated with brachytherapy

Ferrè, Marjorie; Cagetti, Leonel Varela; Zemmour, Christophe; Tyran, Marguerite; Fau, Pierre; Chargari, Cyrus; Tallet, Agnés; Gonzague, Laurence; Annède, Pierre

doi:10.1016/j.brachy.2021.03.008

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…The mean CT1 vs. the mean CT2 volumes (ml) for the bladder, rectum, and sigmoid (mean ±SD) in the IRBT arm were 185.89 ±59.22 vs. 175.43 ±59. 16 The mean D 2cc doses to OARs were also significantly different in comparisons between CT1 and CT2, except for D 2cc doses to the bladder in the ORBT arm (Table 3).…”

Section: Resultsmentioning

confidence: 91%

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Brachytherapy dose changes: comparing in-room and out-room image-guided brachytherapy. A randomized study

Muangwong¹,

Tharavichitkul²,

Sripan³

et al. 2022

jcb

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Purpose: Image-based brachytherapy, involving an image machine and a brachytherapy unit in the same room (in-room brachytherapy [IRBT]), limits patient movements; however, this technique may not be feasible in high workload centers. In this study, we compared changes in the dose and volume of organs at risk (OARs) with out-room brachytherapy (ORBT) technique, in which patients musted be transferred to a waiting room and then transferred back for brachytherapy delivery.Material and methods: This was a randomized prospective study comparing changes in D 2cc doses and volume of OARs during IRBT and ORBT. Patients underwent CT for treatment planning (CT1) installed in brachytherapy loading room, and another CT immediately before brachytherapy (CT2) during each fraction. While patients remained on CT table after CT1 during treatment planning and delivery in IRBT arm, they were transferred out to waiting room and back to CT table in ORBT arm. CT2 was analyzed with CT1 to evaluate any changes in volumes and doses.Results: A total of 294 fractions of brachytherapy were considered. The findings indicated no significant differences in the mean D 2cc changes (Gy) (CT2 minus CT1) to the bladder, rectum, and sigmoid between IRBT and ORBT (mean

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Section: Resultsmentioning

confidence: 91%

“…For the rectum and sigmoid, the volume change can occur from peristalsis and affect contents of the bowels, as can the administration of anti-spasmodic medication, bowel preparation, or rectal gas removal. Therefore, appropriate preparation of the bowel should be considered before the procedure is initiated [16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy dose changes: comparing in-room and out-room image-guided brachytherapy. A randomized study

Muangwong¹,

Tharavichitkul²,

Sripan³

et al. 2022

jcb

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show abstract

“…The first fraction was delivered as soon as possible after the completion of treatment planning. Twenty-four hours later, before the second fraction, a CT scan was done to evaluate the necessity of gas evacuation to avoid rectal anterior wall displacements towards the cervix and high doses [ 24 , 25 ]. If the rectum was filled with gas, the gas was evacuated and a new CT scan was completed.…”

Section: Methodsmentioning

confidence: 99%

Early clinical outcomes of hybrid brachytherapy for locally advanced cervical cancer: making adverse situations in a favorable scenario

Cagetti¹,

Zemmour²,

Lambaudie³

et al. 2022

jcb

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Purpose: To investigate the feasibility and early clinical outcomes of combined intra-cavitary (IC) and interstitial (IS) image-guided adaptive brachytherapy (IGABT) as curative and definitive treatment of patients treated with chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC).Material and methods: Data from medical records of all consecutive patients with histologically proven cervical cancer (FIGO 2018 stage IB-IV), treated by brachytherapy after CCRT at our institution between 2017 and 2020 were reviewed.Results: One hundred and forty-two patients with LACC FIGO 2018 stages (IB: 20.4%, II: 31.7%, III: 45.8%, IV: 2.1%) underwent brachytherapy at our institution, out of which 53.5% underwent combined brachytherapy technique (IC/IS). Median number of implanted catheters was 3 (range, 1-6 catheters). None of the 142 patients required invasive hemorrhage management. With a median follow-up of 21.6 (95% CI [confidence interval]: 19.1-23.5%) months, local relapse was observed in nine patients (6.3%), with four showing persistent and progressive disease. The estimated 2-year local and pelvic relapse-free survival were 92% (95% CI: 84-96%) and 90% (95% CI: 83-94%), respectively. The estimated 2-year disease-free survival for the entire population was 80% (95% CI: 71-87%). The 2-year overall survival (OS) rate for the entire population was 92% (95% CI: 84-96%). Acute toxicity G3 was reported in two (1.4%) patients. High-grade late toxicity (grade 3) was reported in 9 (6.3%) patients.Conclusions: Combined IC/IS brachytherapy for LACC allows for recommended doses to achieve local control even in large tumors after CCRT improving target volume coverage, with low rates of acute morbidity. Hybrid brachytherapy technique (IC/IS) is essential to have a favorable scenario at the time of brachytherapy to correctly treat locally advanced cervical cancer patients.

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Letter to the editor regarding “Reducing dose to rectum by placement of a rectum-emptying tube in cervical cancer patients treated with brachytherapy”

Zeng¹,

Sui²

2022

Brachytherapy

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Reducing dose to rectum by placement of a rectum-emptying tube in cervical cancer patients treated with brachytherapy

Cited by 3 publications

References 9 publications

Brachytherapy dose changes: comparing in-room and out-room image-guided brachytherapy. A randomized study

Brachytherapy dose changes: comparing in-room and out-room image-guided brachytherapy. A randomized study

Early clinical outcomes of hybrid brachytherapy for locally advanced cervical cancer: making adverse situations in a favorable scenario

Letter to the editor regarding “Reducing dose to rectum by placement of a rectum-emptying tube in cervical cancer patients treated with brachytherapy”

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