Publications by authors named "Chopra Supriya"
Can knowledge-based planning models validated on ethnically diverse patients lead to global standardisation of external beam radiation therapy for locally advanced cervix cancer?
Radiother Oncol
December 2024
Background And Purpose: Knowledge-based planning (KBP) can consistently and efficiently create high-quality Volumetric Arc Therapy (VMAT) plans for cervix cancer. This study describes the cross-validation of two KBP models on geographically distinct populations and their comparison to manual plans from 67 centers. The purpose was to determine the universal applicability of a generic KBP model.
View Article and Find Full Text PDFPurpose: To evaluate outcomes of cervical cancer patients treated with abbreviated high dose rate brachytherapy (HDR-BT) that used 2-implants and delivered 4-5 fractions over 7-12 days rather than 21-28 days.
Materials And Methods: Patients with stage IB2-IVA cervical cancer, treated with external beam radiation (EBRT) ± chemotherapy followed by abbreviated MR/CT-based HDR-BT were included. The planning aim was to achieve > 70Gy equivalent doses in 2Gy (EQD2) at Point A dose in patients undergoing intracavitary BT (ICBT) and > 85Gy EQD2 to the HRCTV in intracavitary-interstitial BT (IC-ISBT).
Article Synopsis
- The 2018 revision of the International Federation of Gynaecology and Obstetrics staging has introduced uncertainties in treatment approaches for node-positive cervical cancer patients, leading to a study aimed at identifying those who will benefit from elective para-aortic lymph node (PALN) irradiation.
- This ongoing multicenter phase III clinical trial involves 274 subjects divided into two groups to compare the effectiveness of limited elective PALN irradiation against no irradiation, with a primary focus on 3-year disease-free survival and various secondary endpoints related to survival and quality of life.
- The study has received ethical approval and is set to be monitored according to guidelines, with the intention to publish findings in reputable scientific journals.
The field of gynaecologic oncology has evolved rapidly in recent years, largely driven by advances in both radiotherapy and systemic therapies. These innovations have reshaped the management of key gynaecologic cancers, including cervical, endometrial, vaginal, and vulvar cancers, leading to more personalized and effective treatment approaches. This review explores pivotal clinical trials conducted between 2023 and 2024 that have potentially modified current practices.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to analyze the treatment patterns for brain metastases among radiation oncologists within the Federation of Asian Organizations for Radiation Oncology (FARO).
- Conducted via an online survey, responses were gathered from 32 radiation oncologists across 13 countries, revealing that most worked in academic centers and utilized SRS or fSRT for treatment.
- The results indicated common practices, such as a preference for treating fewer and smaller brain metastases, but highlighted the need for broader surveys that include community hospitals to get a more comprehensive understanding of care patterns.
Among most tailored approaches in radiation oncology, the development of brachytherapy for the treatment of cervical cancer patients has benefited from various technological innovations. The development of 3D image-guided treatments was the first step for treatment personalization. This breakthrough preceded practice homogenization and validation of predictive dose and volume parameters and prognostic factors.
View Article and Find Full Text PDFPurpose: The lack of training is a significant barrier to practicing brachytherapy (BT). Tata Memorial Centre, alongside international BT experts and BrachyAcademy, developed a hybrid gynecological BT training module. This study outlines the preparation, organization, and execution of the 2022-2023 Mumbai training, evaluates its effectiveness, and highlights areas for improvement.
View Article and Find Full Text PDFPurpose: BIOEMBRACE was designed to study the impact of biomarkers in addition to clinicopathological factors on disease outcomes in patients treated with chemoradiation and magnetic resonance imaging (MRI)-guided brachytherapy (BT) for locally advanced cervical cancer in the EMBRACE study.
Methods And Materials: Between 2018 and 2021, 8 EMBRACE-I sites contributed tumor tissue for the immunohistochemistry of p16, PD-L1, and L1CAM. These biomarkers and clinicopathological factors (International Federation of Gynecology and Obstetrics 2009 stage, nodal status, histology, and necrosis on MRI) were analyzed to predict poor response at BT (high-risk clinical target volume [HR-CTV] ≥ 40 cc) at BT) and 5-year local control, pelvic control, and disease-free survival.
Article Synopsis
- The study aimed to compare standard clinico-radiological evaluations with RECIST 1.1 in measuring survival outcomes for cervical cancer patients undergoing chemoradiation and brachytherapy.
- Out of 69 patients, RECIST 1.1 showed lower classification of pathological lymph nodes as target lesions and there was a strong agreement with standard evaluation on disease-free survival (κ value of 0.84) but with slight differences in survival rates.
- Overall, RECIST 1.1 demonstrated good sensitivity (75%), perfect specificity (100%), and high accuracy (97.1%) in detecting treatment responses, resulting in minimal differences in disease-free survival rates across both evaluation methods.
Purpose: To evaluate clinical outcomes of CT-based adaptive intracavitary and interstitial brachytherapy (IC followed by IC-ISBT) in locally advanced cervical cancer (LACC) in resource-constrained settings.
Methods And Materials: LACC patients treated with adaptive brachytherapy techniques were analyzed to evaluate treatment characteristics and clinical outcomes. The Kaplan-Meier method was used for survival analysis, and the log-rank test for univariate analysis.
Article Synopsis
- The PARCER trial provided evidence supporting the use of image-guided intensity-modulated radiation therapy (IG-IMRT) for cervical cancer, emphasizing the need for long-term financial analysis to integrate it into India's cancer treatment guidelines.
- A comparison of costs between IG-IMRT and three-dimensional conformal radiation therapy (3D-CRT) showed that IG-IMRT resulted in lower overall financial impacts, including treatment costs, adverse events, and toxicity management over time.
- Despite higher initial expenses for IG-IMRT, the study concluded 3D-CRT was financially less efficient, suggesting that guidelines should consider long-term costs for adopting advanced radiation treatments.
Background Objectives: There is limited evidence studying the relationship of liver segmental dose and segmental volume changes. The segmental dose thresholds could potentially allow for segmental regeneration after liver stereotactic body radiation therapy (SBRT). Given improved survival in hepatocellular cancer (HCC) and liver metastases and more salvage therapy options, this has become an important clinical question to explore.
View Article and Find Full Text PDFPurpose: The workflow of brachytherapy (BT) is an essential aspect of treatment to consider in image-guided brachytherapy (IGBT). It has an overarching effect influencing patient throughput and the number of cancer treatments that can be performed as it occupies equipment, space, and personnel. There is limited research addressing this issue.
View Article and Find Full Text PDFBackground: State of the art combined radiochemotherapy and image-guided brachytherapy for locally advanced cervical cancer (LACC) has shown improved disease control and survival as well as a significant reduction of organ related morbidity. However, LACC cancer survivors are still experiencing a spectrum of symptoms. The aim of this study was to identify co-occurring symptoms in cervix cancer survivors by using patient-reported outcome and physician assessed morbidity.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on improving the accuracy of pelvic intensity modulated radiation therapy (IMRT) for cervical cancer, which can sometimes miss its target due to variations in patient positioning and organ shapes.
- A phase 2 study involved 50 patients undergoing treated chemoradiotherapy with specific protocols for bladder and rectum filling, while utilizing adaptive image-guided radiotherapy (IGRT) to adjust treatment plans based on daily imaging.
- Results showed significant variation in bladder volume between treatment sessions, with findings indicating that certain factors like chemotherapy sessions affect this variation, which underscores the importance of personalized treatment plans.
Purpose: To evaluate clinical outcomes of recurrent gynaecological cancers treated with reirradiation (reRT) using advanced brachytherapy (BT) technique.
Methods And Materials: Seventy-six women who underwent reRT with BT for gynaecological cancers at our institute between January 2000 and December 2019 were analysed to determine patient, disease and treatment characteristics and clinical outcomes. Descriptive analysis was used for demographics, and the Kaplan Meir method was used for survival analysis.
Article Synopsis
- There is a big problem with cervical cancer in poorer countries because they often don't have good screening and treatment options.
- High-dose-rate (HDR) brachytherapy is a type of treatment that helps people survive and control the cancer better.
- The American Brachytherapy Society and Indian Brachytherapy Society made a guide to help set up these treatment programs in places that lack resources.
Background: High-dose-rate image guided brachytherapy (IGBT) for cervical cancer leads to improved local control and reduced toxicity and is a critical component of treatment. However, transition to IGBT requires capacity upscaling. An institutional activity mapping and national impact analysis of such a transition were undertaken to understand feasibility.
View Article and Find Full Text PDFPurpose: Variations in the levels of systemic inflammatory biomarker levels have been linked with outcomes in various malignancies including cervical cancer. In this study, we investigated prognostic implications of pretreatment hematological factors/indices in locally advanced cervical cancers treated with radical radio(chemo)therapy.
Methods And Materials: Electronic medical records of 1051 patients with cervical cancer of FIGO (International Federation of Gynecology and Obstetrics) stage IB2-IVA treated in various prospective trials at our institute between 2003 and 2017 were reviewed.
Purpose: This survey was conducted to assess the current research practices among the 14 members of the Federation of Asian Organizations for Radiation Oncology (FARO) committee, to inform measures for research capacity building in these nations.
Materials And Methods: A 19-item electronic survey was sent to two research committee members from the 14 representative national radiation oncology organizations (N = 28) that are a part of FARO.
Results: Thirteen of the 14 member organizations (93%) and 20 of 28 members (71.
Introduction: Brachytherapy (BT) is integral in treatment of gynecological malignancies and is also an option for many other cancers. Data on training and proficiency levels of early career oncologists is limited. Like other continents a survey was conducted for early career oncologists in India.
View Article and Find Full Text PDFPurpose: The sigmoid is an important organ at risk for gynecological brachytherapy (BT). However, the reliability of localization of high-dose regions during multi-fractionated treatment is limited. This work reports the methodological development of sigmoid points to summate multi-fractionated doses.
View Article and Find Full Text PDFPurpose: To report the clinical outcomes in patients treated with Martinez universal perineal interstitial template (MUPIT)-based interstitial brachytherapy boost for primary and recurrent vault and vaginal cancers, and to perform a comparative analysis with our previously published series of similar patients.
Material And Methods: One hundred and seventeen patients treated between January, 2009 and December, 2015 were evaluated. Descriptive statistics for the patterns of relapse, local recurrence-free survival (LRFS), disease-free survival (DFS), overall survival (OS), and late toxicities were carried out.
Purpose: To develop and implement a software that enables centers, treating patients with state-of-the-art radiation oncology, to compare their patient, treatment, and outcome data to a reference cohort, and to assess the quality of their treatment approach.
Materials And Methods: A comprehensive data dashboard was designed, which al- lowed holistic assessment of institutional treatment approaches. The software was tested in the ongoing EMBRACE-II study for locally advanced cervical cancer.
Article Synopsis
- The study aimed to assess how ongoing health issues affect quality of life (QOL) in survivors of locally advanced cervical cancer (LACC).
- It involved analyzing data from the EMBRACE-I study, measuring patient-reported symptoms and QOL over time using specific scoring systems, and identifying persistent symptoms throughout follow-ups.
- Results revealed that persistent symptoms significantly impact QOL, especially in areas like role functioning and general well-being, highlighting the need for better management of both general and organ-related symptoms post-treatment.