PURPOSE: To evaluate the outcomes of patients with locally advanced cervical cancer treated with three-dimensional image-guided brachytherapy (IGABT) after concomitant chemoradiation (CCRT). MATERIALS AND METHODS: Data from patients treated with CCRT followed by magnetic resonance imaging-guided or computed tomography-guided pulsed-dose-rate brachytherapy, performed according to the Groupe Européen de Curiethérapie-European Society for Radiotherapy and Oncology guidelines, were reviewed. At first, stage I or II patients systematically underwent radical hysterectomy or were offered a randomized study evaluating hysterectomy. Then, hysterectomy was limited to salvage treatment. RESULTS: Of 163 patients identified, 27% had stage IB, 57% had stage II, 12% had stage III, and 3% had stage IVA disease. The mean dose delivered (in 2-Gy dose equivalents) to 90% of the high-risk clinical target volume was 78.1 ± 9.6 Gy, whereas the doses delivered to organs at risk were maintained under the usual thresholds. Sixty-one patients underwent a hysterectomy. Macroscopic residual disease was found in 13 cases. With a median follow-up of 36 months (range, 5-79 months), 45 patients had relapsed. The 3-year overall survival rate was 76%. Local and pelvic control rates were 92% and 86%, respectively. According to the Common Toxicity Criteria 3.0, 7.4% of patients experienced late grade 3 or 4 toxicity. Most of those had undergone postradiation radical surgery (2.9% vs. 14.8; p = .005). CONCLUSION: IGABT combined with CCRT provides excellent locoregional control rates with low treatment-related morbidity, justifying the elimination of hysterectomy in the absence of obvious residual disease. Distant metastasis remains an important first relapse and may warrant more aggressive systemic treatment.
PURPOSE: To evaluate the outcomes of patients with locally advanced cervical cancer treated with three-dimensional image-guided brachytherapy (IGABT) after concomitant chemoradiation (CCRT). MATERIALS AND METHODS: Data from patients treated with CCRT followed by magnetic resonance imaging-guided or computed tomography-guided pulsed-dose-rate brachytherapy, performed according to the Groupe Européen de Curiethérapie-European Society for Radiotherapy and Oncology guidelines, were reviewed. At first, stage I or II patients systematically underwent radical hysterectomy or were offered a randomized study evaluating hysterectomy. Then, hysterectomy was limited to salvage treatment. RESULTS: Of 163 patients identified, 27% had stage IB, 57% had stage II, 12% had stage III, and 3% had stage IVA disease. The mean dose delivered (in 2-Gy dose equivalents) to 90% of the high-risk clinical target volume was 78.1 ± 9.6 Gy, whereas the doses delivered to organs at risk were maintained under the usual thresholds. Sixty-one patients underwent a hysterectomy. Macroscopic residual disease was found in 13 cases. With a median follow-up of 36 months (range, 5-79 months), 45 patients had relapsed. The 3-year overall survival rate was 76%. Local and pelvic control rates were 92% and 86%, respectively. According to the Common Toxicity Criteria 3.0, 7.4% of patients experienced late grade 3 or 4 toxicity. Most of those had undergone postradiation radical surgery (2.9% vs. 14.8; p = .005). CONCLUSION: IGABT combined with CCRT provides excellent locoregional control rates with low treatment-related morbidity, justifying the elimination of hysterectomy in the absence of obvious residual disease. Distant metastasis remains an important first relapse and may warrant more aggressive systemic treatment.
Authors: Alfonso Dueñas-González; Juan J Zarbá; Firuza Patel; Juan C Alcedo; Semir Beslija; Luis Casanova; Pittayapoom Pattaranutaporn; Shahid Hameed; Julie M Blair; Helen Barraclough; Mauro Orlando Journal: J Clin Oncol Date: 2011-03-28 Impact factor: 44.544
Authors: Kari Tanderup; Dietmar Georg; Richard Pötter; Christian Kirisits; Cai Grau; Jacob C Lindegaard Journal: Semin Radiat Oncol Date: 2010-04 Impact factor: 5.934
Authors: Philippe Morice; Philippe Rouanet; Annie Rey; Pascale Romestaing; Gilles Houvenaeghel; Jean Charles Boulanger; Jean Leveque; Didier Cowen; Patrice Mathevet; Jean Pierre Malhaire; Guillaume Magnin; Eric Fondrinier; Jocelyne Berille; Christine Haie-Meder Journal: Oncologist Date: 2012-01-10
Authors: Nicolas Magné; Cyrus Chargari; Nicholas SanFilippo; Taha Messai; Alain Gerbaulet; Christine Haie-Meder Journal: Brachytherapy Date: 2010-02-13 Impact factor: 2.362
Authors: Richard Pötter; Petra Georg; Johannes C A Dimopoulos; Magdalena Grimm; Daniel Berger; Nicole Nesvacil; Dietmar Georg; Maximilian P Schmid; Alexander Reinthaller; Alina Sturdza; Christian Kirisits Journal: Radiother Oncol Date: 2011-08-05 Impact factor: 6.280
Authors: E Leblanc; F Narducci; L Bresson; J Durand-Labrunie; S Taieb; E Vanlerenberghe; I Farre; P Nickers Journal: Surg Endosc Date: 2014-05-02 Impact factor: 4.584
Authors: R Mazeron; J Gilmore; J Champoudry; I Dumas; J Helou; P Maroun; F Martinetti; A Gerbaulet; C Haie-Meder Journal: Strahlenther Onkol Date: 2013-11-17 Impact factor: 3.621
Authors: Elena Villafranca; Paola Navarrete; Amaya Sola; Juan Carlos Muruzabal; Sara Aguirre; Santiago Ostiz; Carmen Sanchez; Rosa Guarch; Nuria Lainez; Marta Barrado Journal: Rep Pract Oncol Radiother Date: 2018-10-19
Authors: Radovan Vojtíšek; Petr Hošek; Emília Sukovská; Petra Kovářová; Jan Baxa; Jiří Ferda; Jindřich Fínek Journal: Strahlenther Onkol Date: 2022-01-21 Impact factor: 4.033