Pauline Castelnau-Marchand1, Cyrus Chargari2, Pierre Maroun1, Isabelle Dumas3, Eleonor Rivin Del Campo1, Kim Cao1, Claire Petit1, Florent Martinetti3, Alain Tafo-Guemnie3, Dimitri Lefkopoulos4, Philippe Morice5, Christine Haie-Meder1, Renaud Mazeron6. 1. Radiation Oncology, Gustave Roussy Camper Campus, 94805 Villejuif Cedex, France. 2. Radiation Oncology, Gustave Roussy Camper Campus, 94805 Villejuif Cedex, France; Molecular Radiotherapy INSERM 1030, Gustave Roussy Cancer campus, 94805 Villejuif Cedex, France. 3. Medical Physics, Gustave Roussy Cancer Campus, 94805 Villejuif Cedex, France. 4. Molecular Radiotherapy INSERM 1030, Gustave Roussy Cancer campus, 94805 Villejuif Cedex, France; Medical Physics, Gustave Roussy Cancer Campus, 94805 Villejuif Cedex, France. 5. Gynecological Surgery, Gustave Roussy Cancer Campus, 94805 Villejuif Cedex, France. 6. Radiation Oncology, Gustave Roussy Camper Campus, 94805 Villejuif Cedex, France; Molecular Radiotherapy INSERM 1030, Gustave Roussy Cancer campus, 94805 Villejuif Cedex, France. Electronic address: renaud.mazeron@gustaveroussy.fr.
Abstract
OBJECTIVE: To report the outcomes and late toxicities of patients with locally advanced cervical cancer treated with concomitant chemoradiation (CRT) followed by intracavitary image-guided adaptive brachytherapy (IGABT). METHODS: Data from consecutive patients with histologically proven stage IB-IVA cervical cancer treated with curative intent in a single institution were analyzed. After pelvic +/- para-aortic external-beam radiation therapy, they received pulsed-dose rate IGABT following GEC-ESTRO recommendations. RESULTS: Two hundred and twenty-five patients were enrolled. Sixty-five percent were stage≥IIB according to FIGO classification. Ninety-five percent received CRT. Mean D90 to HR and IR-CTV were 80.4+/-10.3Gy and 67.7+/-6.1Gy. After a median follow-up of 38.8months, 3-year local control and overall survival rates were 86.4% and 76.1%, respectively. A trend for a detrimental effect of tumor stage on local control rates was observed with 3-year local control rates of 100% for stages IB1 and IIA, 90.5 for IB2, 85.8% for IIB, 50% for IIIA, 77.1 for IIIB, and 66.7% for IVA tumors (p=0.06). Local control rates at 3years were 95.6% in the group of patients with D90 of HR-CTV≥85Gy, 88.8% in those with D90 between 80 and 85Gy, and 80% when D90<80Gy (p=0.018). Eighteen severe late gastrointestinal and urinary effects affecting 14 patients were reported corresponding with a crude incidence of 6.6%. CONCLUSIONS: CRT followed by IGABT provides high local control rates with limited toxicity. Reaching high doses is mandatory to achieve local control and interstitial brachytherapy is necessary in advanced diseases.
OBJECTIVE: To report the outcomes and late toxicities of patients with locally advanced cervical cancer treated with concomitant chemoradiation (CRT) followed by intracavitary image-guided adaptive brachytherapy (IGABT). METHODS: Data from consecutive patients with histologically proven stage IB-IVA cervical cancer treated with curative intent in a single institution were analyzed. After pelvic +/- para-aortic external-beam radiation therapy, they received pulsed-dose rate IGABT following GEC-ESTRO recommendations. RESULTS: Two hundred and twenty-five patients were enrolled. Sixty-five percent were stage≥IIB according to FIGO classification. Ninety-five percent received CRT. Mean D90 to HR and IR-CTV were 80.4+/-10.3Gy and 67.7+/-6.1Gy. After a median follow-up of 38.8months, 3-year local control and overall survival rates were 86.4% and 76.1%, respectively. A trend for a detrimental effect of tumor stage on local control rates was observed with 3-year local control rates of 100% for stages IB1 and IIA, 90.5 for IB2, 85.8% for IIB, 50% for IIIA, 77.1 for IIIB, and 66.7% for IVA tumors (p=0.06). Local control rates at 3years were 95.6% in the group of patients with D90 of HR-CTV≥85Gy, 88.8% in those with D90 between 80 and 85Gy, and 80% when D90<80Gy (p=0.018). Eighteen severe late gastrointestinal and urinary effects affecting 14 patients were reported corresponding with a crude incidence of 6.6%. CONCLUSIONS: CRT followed by IGABT provides high local control rates with limited toxicity. Reaching high doses is mandatory to achieve local control and interstitial brachytherapy is necessary in advanced diseases.
Authors: Junzo Chino; Christina M Annunziata; Sushil Beriwal; Lisa Bradfield; Beth A Erickson; Emma C Fields; KathrynJane Fitch; Matthew M Harkenrider; Christine H Holschneider; Mitchell Kamrava; Eric Leung; Lilie L Lin; Jyoti S Mayadev; Marc Morcos; Chika Nwachukwu; Daniel Petereit; Akila N Viswanathan Journal: Pract Radiat Oncol Date: 2020-05-18
Authors: L T Tan; K Tanderup; A Nappa; P Petric; I M Jürgenliemk-Schulz; M Serban; J V Swamidas; M Palmu; S L Duke; U Mahantshetty; N Nesvacil; R C Pötter; R A Nout Journal: Clin Transl Radiat Oncol Date: 2021-06-15
Authors: Peter de Boer; Agustinus J A J van de Schoot; Henrike Westerveld; Mark Smit; Marrije R Buist; Arjan Bel; Coen R N Rasch; Lukas J A Stalpers Journal: Strahlenther Onkol Date: 2017-11-03 Impact factor: 3.621