Purpose: To assess the importance of the information obtained from MRI for adaptive cervix cancer radiotherapy.
Patients And Methods: 49 patients with cervix cancer, treated by external-beam radiotherapy (EBRT) and MRI-assisted high-dose-rate brachytherapy +/- concomitant cisplatin, underwent MRI at diagnosis and at the time of brachytherapy fractions. 190 MRI examinations were performed. Pretreatment scans were correlated with clinical examination (CE) findings. Measurements in 3-D of the tumor extension and also of the distance from the tumor to the pelvic side wall were performed using both MRI and CE. The tumor volume regression induced initially by EBRT and the subsequent regression after each brachytherapy fraction were assessed.
Results: MRI and CE showed 92% agreement in overall parametrial staging and 73% agreement in terms of vaginal involvement. There was, however, disagreement in parametrial side (right/left) classification in 25% of the parametria examined. These were patients with unilateral displacement of the cervix and contralateral invasion of the parametrium. The mean tumor volume on the pretreatment MRI scan (GTVD) was 61 cm(3). At the time of the four brachytherapy fractions the mean was 16 cm(3), 10 cm(3), 9 cm(3), and 8 cm(3), defined as the GTVBT plus the gray zones in the parametria.
Conclusion: CE and MRI findings agree well in terms of overall staging. The clinical assessment of side-specific parametrial invasion improved when having access to the additional knowledge obtained from MRI. The greatest decrease in tumor volume occurs during EBRT, whereas tumor regression between the first and subsequent brachytherapy fractions is minor.
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http://dx.doi.org/10.1007/s00066-009-1918-7 | DOI Listing |
Clin Oncol (R Coll Radiol)
December 2024
Department of Oncology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2PG, UK. Electronic address:
Aims: Brachytherapy is advantageous for localised rhabdomyosarcomas in children compared with external beam radiotherapy, sparing close organs at risk with highly conformal dosimetry. A methodology for planning and delivering fractionated high-dose-rate paediatric pelvic brachytherapy is detailed, and the dosimetric parameters are presented. This provides a practical template for radiotherapy departments with a similar patient cohort to implement this treatment technique.
View Article and Find Full Text PDFBrachytherapy
December 2024
Medical Affairs, Varian Medical Systems, Inc., Palo Alto, CA; Department of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA. Electronic address:
Aim: To demonstrate how workshop and mentoring across a network of radiotherapy centers helped in transitioning from point A to volume-based image guided brachytherapy in carcinoma cervix.
Materials And Methods: Based on discussion with different centers across the network, the lapses in cervical cancer treatment were identified and a workshop was designed to change the practice pattern. The main focus of the workshop was to streamline EBRT dose prescription protocols and implement volume based image guided brachytherapy through mentoring and hands on training.
Brachytherapy
December 2024
Department of Physics, Mwalimu Julius K. Nyerere University of Agriculture and Technology, Musoma, Tanzania.
Background And Purpose: Cervical cancer is the most prevalent type of cancer among women in numerous low and middle-income countries. Tandem-based applicator is a widely used technique in High Dose Rate Intercavitary Brachytherapy (HDR-ICBT) for treating cervical cancer. For cases where central tandem insertion is not feasible due to patient-specific conditions, a ring-only applicator is used as an alternative.
View Article and Find Full Text PDFJ Contemp Brachytherapy
October 2024
Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
Purpose: To present an innovative deformable applicator that used Freiburg flap as vaginal applicator with or without free-hand interstitial needles in three-dimensional (3D) high-dose-rate (HDR) brachytherapy for vaginal stump recurrence of cervical cancer.
Material And Methods: Between September 2017 and January 2020, all patients with vaginal stump recurrence after radical hysterectomy of cervical cancer treated with vaginal stump brachytherapy using Freiburg flap as vaginal applicator with or without free-hand interstitial needles were retrospective analyzed. Characteristics related to patients and treatment modality as well as preliminary outcomes and side effects were investigated.
J Contemp Brachytherapy
October 2024
Department of Radiation Oncology, Cancer Institute, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Purpose: Non-melanoma skin cancer (NMSC) is the most prevalent cancer worldwide, particularly affecting head and neck region. Surgical excision, especially Moh's microsurgery, is the gold standard for treatment. However, certain patients' factors, such as age, comorbidities, and tumor location, require alternative therapies.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!