skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer

Abstract

Purpose: To evaluate the long-term results of computed tomography (CT)–planned high-dose-rate (HDR) brachytherapy (BT) for treating cervical cancer patients. Methods and Materials: CT-planned HDR BT was performed according to the adapted Group European de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations in 216 consecutive patients with locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stage IB to IVA, who were treated with conformal external beam radiation therapy and concomitant chemotherapy. We analyzed outcomes and late side effects evaluated according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer and Subjective, Objective, Management, Analysis evaluation scoring system and compared them with the results from a historical group. Results: The median age was 56 years (range, 32-83 years). The median follow-up time for living patients was 52 months (range 37-63 months). The 5-year cumulative incidence function for the local recurrence rate for patients with FIGO II and III was 5.5% and 20%, respectively (P=.001). The 5-year rates of overall survival (OS) and disease-free survival (DFS) were 66.4% and 58.5%, respectively. The relative risk of failure for OS and DFS for FIGO III in relation to FIGO II was 2.24 (P=.003) and 2.6 (P=.000) and for lymph nodemore » enlargement was 2.3 (P=.002) and 2 (P=.006), respectively. In 2 patients, rectovaginal fistula occurred, and in 1 patient, vesicovaginal fistula occurred without local progression. Comparison of late adverse effects in patients treated according to the GEC-ESTRO recommendations and in the historical group revealed a reduction in fistula formation of 59% and also a reduction in rectal grade 3 to 4 late toxicity of >59%. Conclusions: This is the largest report with mature data of CT-planned BT HDR for the treatment of cervical cancer with good local control and acceptable toxicity. In comparison with the historical series, there is a substantial benefit in terms of severe late effects. FIGO III and enlarged lymph nodes in positron emission tomography–CT/CT are negative prognostic factors, both with a relative risk of failure of approximately 2.« less

Authors:
 [1]; ;  [2];  [3];  [1];  [3];  [4]; ;  [2]
  1. Department of Brachytherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)
  2. Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)
  3. Department of Teleradiotherapy, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)
  4. Department of Clinical Trials and Biostatistics, The Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)
Publication Date:
OSTI Identifier:
22648784
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 1; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; CHEMOTHERAPY; EXTERNAL BEAM RADIATION THERAPY; LYMPH NODES; NEOPLASMS; PATIENTS; RADIATION HAZARDS; SIDE EFFECTS

Citation Formats

Zolciak-Siwinska, Agnieszka, E-mail: agnieszka.zolciak@wp.pl, Gruszczynska, Ewelina, Bijok, Michal, Jonska-Gmyrek, Joanna, Dabkowski, Mateusz, Staniaszek, Jagna, Michalski, Wojciech, Kowalczyk, Adam, and Milanowska, Katarzyna. Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.04.025.
Zolciak-Siwinska, Agnieszka, E-mail: agnieszka.zolciak@wp.pl, Gruszczynska, Ewelina, Bijok, Michal, Jonska-Gmyrek, Joanna, Dabkowski, Mateusz, Staniaszek, Jagna, Michalski, Wojciech, Kowalczyk, Adam, & Milanowska, Katarzyna. Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer. United States. doi:10.1016/J.IJROBP.2016.04.025.
Zolciak-Siwinska, Agnieszka, E-mail: agnieszka.zolciak@wp.pl, Gruszczynska, Ewelina, Bijok, Michal, Jonska-Gmyrek, Joanna, Dabkowski, Mateusz, Staniaszek, Jagna, Michalski, Wojciech, Kowalczyk, Adam, and Milanowska, Katarzyna. Thu . "Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer". United States. doi:10.1016/J.IJROBP.2016.04.025.
@article{osti_22648784,
title = {Computed Tomography–Planned High-Dose-Rate Brachytherapy for Treating Uterine Cervical Cancer},
author = {Zolciak-Siwinska, Agnieszka, E-mail: agnieszka.zolciak@wp.pl and Gruszczynska, Ewelina and Bijok, Michal and Jonska-Gmyrek, Joanna and Dabkowski, Mateusz and Staniaszek, Jagna and Michalski, Wojciech and Kowalczyk, Adam and Milanowska, Katarzyna},
abstractNote = {Purpose: To evaluate the long-term results of computed tomography (CT)–planned high-dose-rate (HDR) brachytherapy (BT) for treating cervical cancer patients. Methods and Materials: CT-planned HDR BT was performed according to the adapted Group European de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) recommendations in 216 consecutive patients with locally advanced cervical cancer, International Federation of Gynecology and Obstetrics (FIGO) stage IB to IVA, who were treated with conformal external beam radiation therapy and concomitant chemotherapy. We analyzed outcomes and late side effects evaluated according to the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer and Subjective, Objective, Management, Analysis evaluation scoring system and compared them with the results from a historical group. Results: The median age was 56 years (range, 32-83 years). The median follow-up time for living patients was 52 months (range 37-63 months). The 5-year cumulative incidence function for the local recurrence rate for patients with FIGO II and III was 5.5% and 20%, respectively (P=.001). The 5-year rates of overall survival (OS) and disease-free survival (DFS) were 66.4% and 58.5%, respectively. The relative risk of failure for OS and DFS for FIGO III in relation to FIGO II was 2.24 (P=.003) and 2.6 (P=.000) and for lymph node enlargement was 2.3 (P=.002) and 2 (P=.006), respectively. In 2 patients, rectovaginal fistula occurred, and in 1 patient, vesicovaginal fistula occurred without local progression. Comparison of late adverse effects in patients treated according to the GEC-ESTRO recommendations and in the historical group revealed a reduction in fistula formation of 59% and also a reduction in rectal grade 3 to 4 late toxicity of >59%. Conclusions: This is the largest report with mature data of CT-planned BT HDR for the treatment of cervical cancer with good local control and acceptable toxicity. In comparison with the historical series, there is a substantial benefit in terms of severe late effects. FIGO III and enlarged lymph nodes in positron emission tomography–CT/CT are negative prognostic factors, both with a relative risk of failure of approximately 2.},
doi = {10.1016/J.IJROBP.2016.04.025},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 96,
place = {United States},
year = {Thu Sep 01 00:00:00 EDT 2016},
month = {Thu Sep 01 00:00:00 EDT 2016}
}