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Stereotactic body radiotherapy boost as an alternative to brachytherapy for cervical cancer: A scoping review. | LitMetric

Stereotactic body radiotherapy boost as an alternative to brachytherapy for cervical cancer: A scoping review.

Crit Rev Oncol Hematol

Division of Clinical Research and Technological Development, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil; Oncoclínicas&Co - Medica Scientia Innovation Research (MEDSIR), São Paulo, Brazil.

Published: December 2024

AI Article Synopsis

  • This scoping review evaluates stereotactic body radiotherapy (SBRT) as a potential alternative to brachytherapy (BCT) for cervical cancer treatment in patients who can't receive BCT.
  • Sixteen studies were analyzed, showing high local control rates for SBRT boosts (up to 100% at 1 year) with low toxicity levels.
  • The conclusion highlights SBRT boost as a promising option for certain patients, but further research is needed to optimize treatment protocols and assess long-term effectiveness and costs.

Article Abstract

Purpose: This scoping review aims to evaluate the evidence for stereotactic body radiotherapy (SBRT) boost as a potential alternative for brachytherapy (BCT) in treating cervical cancer.

Material And Methods: A comprehensive literature search was conducted across multiple databases. Studies investigating SBRT boost in cervical cancer patients who were either contraindicated for or refused BCT were included. The review examined SBRT efficacy and safety.

Results: Sixteen studies were included, encompassing prospective (n = 4) and retrospective cohort studies (n = 8), as well as phase I and II trials (n = 4). The most common SBRT boost dose was 25 Gray(Gy)/5 fractions (ranging from 18 to 40 Gy/3-5 fractions). Local control rates at 1-year, 3-year, and 5-year ranged from 86 % to 100 %, 78-92 %, and 81-92 %, respectively. Overall survival (OS) rates at 1-year, 3-year, and 5-year rates ranged from 49 % to 95 %, 50-77 %, and 50-69 %, respectively. Two studies reported a pathological complete response rate of 93 % and 94 % three months after the SBRT boost. Most studies reported low rates of late grade 3 or higher genitourinary (0-14 %) and gastrointestinal (0-26 %) toxicities. The overall incidence of rectovaginal fistulas ranged from 0 % to 13 %.

Conclusion: This scoping review suggests SBRT boost as a promising alternative to selected cervical cancer patients who cannot receive BCT. The results indicate a high local control with acceptable toxicity profiles. However, further research is needed to define optimal SBRT boost parameters, identify patient selection criteria, and address knowledge gaps regarding long-term outcomes and cost-effectiveness.

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Source
http://dx.doi.org/10.1016/j.critrevonc.2024.104517DOI Listing

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