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Should helical tomotherapy replace brachytherapy for cervical cancer? Case report

Abstract

Stereotactic body radiation therapy (SBRT) administered via a helical tomotherapy (HT) system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI) showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO) stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT) followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were  More>>
Authors:
Hsieh, Chen-Hsi; [1]  Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)]; Wei, Ming-Chow; [2]  Hsu, Yao-Peng; [3]  Chong, Ngot-Swan; [1]  Chen, Yu-Jen; [4]  Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China); Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan (China); Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan (China)]; Hsiao, Sheng-Mou; [2]  Hsieh, Yen-Ping; [5]  Wang, Li-Ying; [6]  Shueng, Pei-Wei; [1]  Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan (China)]
  1. Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan (China)
  2. Departments of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Taipei, Taiwan (China)
  3. Departments of Anatomic Pathology, Far Eastern Memorial Hospital, Taipei, Taiwan (China)
  4. Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)
  5. Department of Healthcare Administration, Asia University, Taichung, Taiwan (China)
  6. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan (China)
Publication Date:
Nov 23, 2010
Product Type:
Journal Article
Resource Relation:
Journal Name: BMC cancer (Online); Journal Volume: 10; Other Information: PMCID: PMC3001446; PUBLISHER-ID: 1471-2407-10-637; PMID: 21092235; OAI: oai:pubmedcentral.nih.gov:3001446; Copyright (c)2010 Hsieh et al; licensee BioMed Central Ltd.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0) (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.; Country of input: International Atomic Energy Agency (IAEA)
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; BRACHYTHERAPY; CARCINOMAS; CT-GUIDED RADIOTHERAPY; GYNECOLOGY; LIVER; LUNGS; NAUSEA; PATIENTS; TOXICITY; UTERUS; VOMITING; WOMEN
OSTI ID:
22393061
Country of Origin:
United Kingdom
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1471-2407; TRN: GB15$3681098758
Availability:
Available from http://dx.doi.org/10.1186/1471-2407-10-637; Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001446
Submitting Site:
INIS
Size:
page(s) 637
Announcement Date:
Nov 05, 2015

Citation Formats

Hsieh, Chen-Hsi, Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)], Wei, Ming-Chow, Hsu, Yao-Peng, Chong, Ngot-Swan, Chen, Yu-Jen, Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China), Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan (China), Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan (China)], Hsiao, Sheng-Mou, Hsieh, Yen-Ping, Wang, Li-Ying, Shueng, Pei-Wei, and Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan (China)]. Should helical tomotherapy replace brachytherapy for cervical cancer? Case report. United Kingdom: N. p., 2010. Web. doi:10.1186/1471-2407-10-637.
Hsieh, Chen-Hsi, Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)], Wei, Ming-Chow, Hsu, Yao-Peng, Chong, Ngot-Swan, Chen, Yu-Jen, Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China), Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan (China), Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan (China)], Hsiao, Sheng-Mou, Hsieh, Yen-Ping, Wang, Li-Ying, Shueng, Pei-Wei, & Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan (China)]. Should helical tomotherapy replace brachytherapy for cervical cancer? Case report. United Kingdom. https://doi.org/10.1186/1471-2407-10-637
Hsieh, Chen-Hsi, Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)], Wei, Ming-Chow, Hsu, Yao-Peng, Chong, Ngot-Swan, Chen, Yu-Jen, Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China), Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan (China), Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan (China)], Hsiao, Sheng-Mou, Hsieh, Yen-Ping, Wang, Li-Ying, Shueng, Pei-Wei, and Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan (China)]. 2010. "Should helical tomotherapy replace brachytherapy for cervical cancer? Case report." United Kingdom. https://doi.org/10.1186/1471-2407-10-637.
@misc{etde_22393061,
title = {Should helical tomotherapy replace brachytherapy for cervical cancer? Case report}
author = {Hsieh, Chen-Hsi, Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan (China)], Wei, Ming-Chow, Hsu, Yao-Peng, Chong, Ngot-Swan, Chen, Yu-Jen, Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan (China), Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan (China), Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan (China)], Hsiao, Sheng-Mou, Hsieh, Yen-Ping, Wang, Li-Ying, Shueng, Pei-Wei, and Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan (China)]}
abstractNote = {Stereotactic body radiation therapy (SBRT) administered via a helical tomotherapy (HT) system is an effective modality for treating lung cancer and metastatic liver tumors. Whether SBRT delivered via HT is a feasible alternative to brachytherapy in treatment of locally advanced cervical cancer in patients with unusual anatomic configurations of the uterus has never been studied. A 46-year-old woman presented with an 8-month history of abnormal vaginal bleeding. Biopsy revealed squamous cell carcinoma of the cervix. Magnetic resonance imaging (MRI) showed a cervical tumor with direct invasion of the right parametrium, bilateral hydronephrosis, and multiple uterine myomas. International Federation of Gynecology and Obstetrics (FIGO) stage IIIB cervical cancer was diagnosed. Concurrent chemoradiation therapy (CCRT) followed by SBRT delivered via HT was administered instead of brachytherapy because of the presence of multiple uterine myomas with bleeding tendency. Total abdominal hysterectomy was performed after 6 weeks of treatment because of the presence of multiple uterine myomas. Neither pelvic MRI nor results of histopathologic examination at X-month follow-up showed evidence of tumor recurrence. Only grade 1 nausea and vomiting during treatment were noted. Lower gastrointestinal bleeding was noted at 14-month follow-up. No fistula formation and no evidence of haematological, gastrointestinal or genitourinary toxicities were noted on the most recent follow-up. CCRT followed by SBRT appears to be an effective and safe modality for treatment of cervical cancer. Larger-scale studies are warranted.}
doi = {10.1186/1471-2407-10-637}
journal = []
volume = {10}
journal type = {AC}
place = {United Kingdom}
year = {2010}
month = {Nov}
}