The prediction of late rectal complications in patients treated with high dose-rate brachytherapy for carcinoma of the cervix

Clark, Brenda; Souhami, Luís; Roman, Ted N.; Chappell, Rick; Evans, Michael D.; Fowler, Jack F.

doi:10.1016/s0360-3016(97)00074-6

Cited by 84 publications

(57 citation statements)

References 12 publications

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“…By mirroring BT fractionation experience while respecting dosimetric/volumetric constraints (73), an established BED (associated with a specific outcome) can guide the selection of optimum SBRT/IMRT dose/ fractionation schedule. Yet, such correlation is hard to define: While Petereit et al could not relate the BED at Point A with either pelvic control or toxicity (74), other investigators demonstrated excessive toxicity as rectal BED 3 exceeded certain threshold [>125 Gy 3 for rectal point (75,76) or >140 Gy 3 for rectal maximum dose (77)]. Similar association between LC/toxicity and BED could not be elucidated based on the current SBRT/IMRT boost studies.…”

Section: Clinical Evidence Supporting Brachytherapy Alternativesmentioning

confidence: 90%

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

Mahmoud¹,

Kilic²,

Khan³

et al. 2017

Ann. Transl. Med.

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The management of locally advanced cervical cancer relies on brachytherapy (BT) as an integral part of the radiotherapy delivery armamentarium. Occasionally, intracavitary BT is neither possible nor available. In these circumstances, post-external beam radiotherapy (EBRT) interstitial brachytherapy and/or hysterectomy may represent viable options that must be adequately executed in a timely manner. However, if these options are not applicable due to patient related or facility related reasons, a formal contingency plan should be in place. Innovative EBRT techniques such as intensity modulated and stereotactic radiotherapy may be considered for patients unable to undergo brachytherapy. Relying on provocative arguments and recent data, this review explores the rationale for and limitations of non-brachytherapy substitutes in that setting aiming to establish a formal process for the optimal execution of this alternative plan.

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Section: Clinical Evidence Supporting Brachytherapy Alternativesmentioning

confidence: 90%

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

Mahmoud¹,

Kilic²,

Khan³

et al. 2017

Ann. Transl. Med.

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“…Some investigators also have analyzed in their HDR studies the relation between the incidence of late complications and the dose to the rectum. Clark et al 32 reported that the BED at the rectal reference point was correlated significantly with the incidence of late rectal complications, and they found a threshold of 125 Gy 3 at the rectal reference point for severe complication. Ogino et al 33 demonstrated that the calculated incidence of major rectal complications ranged from 5-10% at BED from 119 to 146 Gy 3.…”

Section: Discussionmentioning

confidence: 99%

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Nakano

Kato

Ohno³

et al. 2004

Cancer

146

100

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BACKGROUNDThe authors performed a long‐term follow‐up study to evaluate the efficacy and late toxicity of high‐dose rate intracavitary brachytherapy (HDR‐ICBT) for cervical carcinoma.METHODSFrom 1968 to 1986, 1148 patients with Stage IB to IVB squamous cell carcinoma of the cervix (staging was performed according to the International Federation of Gynecology and Obstetrics) were treated with a combination of external beam radiotherapy (EBRT) and HDR‐ICBT. For patients with early‐stage disease, 20 gray (Gy) of EBRT was delivered to the whole pelvis, followed by 24 Gy/4 fractions of HDR‐ICBT and 30 Gy of central‐shielding EBRT. For patients with advanced‐stage disease, 20–40 Gy of whole pelvic EBRT was administered, followed by 24 Gy/4 fractions of ICBT and 30–10 Gy of central‐shielding EBRT. The overall treatment time was approximately 6 weeks. Among survivors, the follow‐up rate was 98% and the median follow‐up duration was 22 years.RESULTSThe 10‐year pelvic tumor control rates were 93% for patients with Stage IB disease, 82% for patients with Stage II disease, and 75% for patients with Stage III disease. The 10‐year overall and cause‐specific survival rates were 74% and 89% for patients with Stage IB disease, 52% and 74% for patients with Stage II disease, and 42% and 59% for patients with Stage III disease, respectively. The 10‐year actuarial rates of major complications were 4.4% in the rectosigmoid colon, 0.9% in the bladder, and 3.3% in the small intestines.CONCLUSIONSThe results of the current study suggest that the combination of EBRT and HDR‐ICBT according to the authors' protocol provided outcomes that were comparable to those of the conventional low‐dose rate brachytherapy with acceptable rates of late complications in the treatment of cervical carcinoma. Cancer 2005. © 2004 American Cancer Society.

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“…Several investigators [13][14][15][16][17]31 have sought to establish a correlation between LRC and the total BED RP . Conceptually, both EBRT and HDR-ICR can result in LRC in patients with cervical carcinoma; thus, the cumulative rectal dose potentially is more valuable for predicting the risk of LRC than other dosimetric parameters (EBRT dose, RP ratio, MP ratio, fraction size of ICR).…”

Section: Discussionmentioning

confidence: 99%

“…This dose corresponded to a BED of 120 -128 Gy 3 . Clark and colleagues 14 reviewed 43 patients with uterine cervical carcinoma who were treated with EBRT and HDR-ICR. They demonstrated a strong correlation between the risk of LRC Ն Grade 3 and a BED RP Ͼ 125 Gy 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Several investigators [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] previously demonstrated that various clinical and treatment-related parameters, including age, diabetes mellitus, disease stage, EBRT dose, fractionation of brachytherapy, Point A dose, and rectal dose, were correlated with late rectal complications (LRC). In particular, RT dose and volume are considered the most important parameters associated with LRC.…”

mentioning

confidence: 99%

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Dosimetric parameters that predict late rectal complications after curative radiotherapy in patients with uterine cervical carcinoma

Kim

Choi

Park

et al. 2005

Cancer

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Expertise‐seeking research studies how people search for expertise and choose whom to contact in the context of a specific task. An important outcome are models that identify factors that influence expert finding. Expertise retrieval addresses the same problem, expert finding, but from a system‐centered perspective. The main focus has been on developing content‐based algorithms similar to document search. These algorithms identify matching experts primarily on the basis of the textual content of documents with which experts are associated. Other factors, such as the ones identified by expertise‐seeking models, are rarely taken into account. In this article, we extend content‐based expert‐finding approaches with contextual factors that have been found to influence human expert finding. We focus on a task of science communicators in a knowledge‐intensive environment, the task of finding similar experts, given an example expert. Our approach combines expertise‐seeking and retrieval research. First, we conduct a user study to identify contextual factors that may play a role in the studied task and environment. Then, we design expert retrieval models to capture these factors. We combine these with content‐based retrieval models and evaluate them in a retrieval experiment. Our main finding is that while content‐based features are the most important, human participants also take contextual factors into account, such as media experience and organizational structure. We develop two principled ways of modeling the identified factors and integrate them with content‐based retrieval models. Our experiments show that models combining content‐based and contextual factors can significantly outperform existing content‐based models.

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The prediction of late rectal complications in patients treated with high dose-rate brachytherapy for carcinoma of the cervix

Cited by 84 publications

References 12 publications

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Dosimetric parameters that predict late rectal complications after curative radiotherapy in patients with uterine cervical carcinoma

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