The application of magnetic resonance image (MRI)-guided brachytherapy has demonstrated significant growth during the past 2 decades. Clinical improvements in cervix cancer outcomes have been linked to the application of repeated MRI for identification of residual tumor volumes during radiotherapy. This has changed clinical practice in the direction of individualized dose administration, and resulted in mounting evidence of improved clinical outcome regarding local control, overall survival as well as morbidity. MRI-guided prostate high-dose-rate and low-dose-rate brachytherapies have improved the accuracy of target and organs-at-risk delineation, and the potential exists for improved dose prescription and reporting for the prostate gland and organs at risk. Furthermore, MRI-guided prostate brachytherapy has significant potential to identify prostate subvolumes and dominant lesions to allow for dose administration reflecting the differential risk of recurrence. MRI-guided brachytherapy involves advanced imaging, target concepts, and dose planning. The key issue for safe dissemination and implementation of high-quality MRI-guided brachytherapy is establishment of qualified multidisciplinary teams and strategies for training and education.
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| http://dx.doi.org/10.1016/j.semradonc.2014.02.007 | DOI Listing |
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Evaluation of plan quality, safety, and toxicity of brachytherapy for locally advanced cervical cancer in an Australian setting following changes in prescription and applicator design.
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Introduction: Chemoradiotherapy with MRI-guided brachytherapy boosts is the standard of care for locally advanced cervical cancer. Data from the RetroEMBRACE and EMBRACE I trials provide dose-response curves for target volumes and OAR. This study evaluated plan quality, safety and toxicity following escalation of the CTV_HR D90 prescription from 80-90 Gy to 85-95 Gy for two different applicator designs.
View Article and Find Full Text PDFMRI-guided brachytherapy for cervical cancer treatment: The significance of bladder morphology in dose distribution planning.
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Department of Radiation Oncology, Keimyung University, Dongsan Hospital, Dalgubeol-daero, Daegu, South Korea.
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Material And Methods: The study enrolled 269 patients who underwent 3D-optimized ICBT guided by MRI scans between 2016 and 2022. Bladder shape (categorized as tilted, curved, or E) was determined based on specific applicators used.
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Article Synopsis
- The study aimed to compare the effectiveness and safety of different brachytherapy planning methods for treating locally advanced cervical cancer, specifically between CT and MRI-based approaches.
- A total of 106 patients were analyzed, with results indicating no significant difference in survival rates between the two methods, but MRI-based planning with the Template Benidorm resulted in smaller treatment volumes and reduced toxicity.
- The findings suggested that MRI planning allows for better treatment precision, leading to decreased rectal hemorrhage and a trend towards higher doses delivered to the tumor site without increasing overall toxicity.
Treating a Refractory Locally Advanced Carcinoma of the Cervix With Cone-Beam Computed Tomography-Based Adaptive External Beam Radiotherapy: A Case Report.
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Adaptive radiotherapy (ART) refers to methods that allow a radiation therapy plan to be adjusted based on images obtained during the treatment. Using cutting-edge imaging methods such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), ART can adjust the treatment plan in response to observed changes in anatomy and even biology while the patient is receiving treatment. The backbone of ART is intensity-modulated RT (IMRT), which permits better sparing of normal critical organs while still delivering a uniform dose to target tumor volume.
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