Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences
Purpose Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late to...
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| Veröffentlicht in: | Strahlentherapie und Onkologie 2022-09, Vol.198 (9), p.783-791 |
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| creator | Vojtíšek, Radovan Hošek, Petr Sukovská, Emília Kovářová, Petra Baxa, Jan Ferda, Jiří Fínek, Jindřich |
| description | Purpose
Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late toxicities, and dosimetric findings.
Methods
Between May 2012 and October 2020, we performed a total of 544 uterovaginal IGABT applications in 131 consecutive patients with biopsy-proven cervical carcinoma not suitable for surgery. The median duration of follow-up was 43 months.
Results
The estimated 3‑, 4‑, and 5‑year LC rates were 88.3% (95% confidence interval [CI] 81.1–95.5), 86.9% (95% CI 78.5–95.3), and 85.5% (95% CI 76–95%), respectively. The 3‑, 4‑, and 5‑year OS estimates were 72.66% (95% CI 63.64–81.69%), 68.9% (95% CI 59.15–78.66%), and 63.96% (95% CI 52.94–74.97%), respectively. Patients who received ≥ 5 cycles of chemotherapy had statistically significantly better 3‑year recurrence-free survival (RFS) compared to patients who completed |
| doi_str_mv | 10.1007/s00066-021-01887-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2622281469</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2622281469</sourcerecordid><originalsourceid>FETCH-LOGICAL-c305t-1fdfa38d34439fc66c650e8572639d309e9b4a7c99e56ca8c053ee8559a2a90e3</originalsourceid><addsrcrecordid>eNp9kc9rFDEUx4Modq3-Ax4k4MVL9GUyySTepGgtVAqlgreQzbzppswvk8y6e-8f3tRtFTx4Cnnv83kv4UvIaw7vOUDzIQGAUgwqzoBr3bDdE7LitTAMjPnxlKyAN4Y1XOoj8iKlGwCualM_J0dCgjSNNCtyexXR5QHHTKcl-2nARKeOfrs8Y9dLaLGlrnVzDluk6-j8Zp83GN28p2Gks8uhiIn-CnlD-8m7vt8XfutGX0SPcRtKjfr7e_xYlJRDXnKYxlLF3Yyx-B7TS_Ksc33CVw_nMfn-5fPVyVd2fnF6dvLpnHkBMjPetZ0TuhV1-WPnlfJKAmrZVEqYVoBBs65d441BqbzTHqTA0pfGVc4AimPy7jB3jtPPBVO2Q0ge-96NOC3JVqqqKs1rZQr69h_0ZlpieXehGpDacK7rQlUHyscppYidnWMYXNxbDvY-I3vIyJaM7O-M7K5Ibx5GL-sB2z_KYygFEAcgldZ4jfHv7v-MvQMpV5-o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2705891184</pqid></control><display><type>article</type><title>Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences</title><source>SpringerLink Journals - AutoHoldings</source><creator>Vojtíšek, Radovan ; Hošek, Petr ; Sukovská, Emília ; Kovářová, Petra ; Baxa, Jan ; Ferda, Jiří ; Fínek, Jindřich</creator><creatorcontrib>Vojtíšek, Radovan ; Hošek, Petr ; Sukovská, Emília ; Kovářová, Petra ; Baxa, Jan ; Ferda, Jiří ; Fínek, Jindřich</creatorcontrib><description>Purpose
Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late toxicities, and dosimetric findings.
Methods
Between May 2012 and October 2020, we performed a total of 544 uterovaginal IGABT applications in 131 consecutive patients with biopsy-proven cervical carcinoma not suitable for surgery. The median duration of follow-up was 43 months.
Results
The estimated 3‑, 4‑, and 5‑year LC rates were 88.3% (95% confidence interval [CI] 81.1–95.5), 86.9% (95% CI 78.5–95.3), and 85.5% (95% CI 76–95%), respectively. The 3‑, 4‑, and 5‑year OS estimates were 72.66% (95% CI 63.64–81.69%), 68.9% (95% CI 59.15–78.66%), and 63.96% (95% CI 52.94–74.97%), respectively. Patients who received ≥ 5 cycles of chemotherapy had statistically significantly better 3‑year recurrence-free survival (RFS) compared to patients who completed <5 cycles (79.07% [95% CI 60.81–97.34] vs. 58.10% [95% CI 47.22–68.98];
p
= 0.0185). We recorded manifestations of genitourinary and gastrointestinal toxicity grade ≥3 in 6.9% and 5.3%, respectively.
Conclusion
Our mature long-term data on the treatment patients with locally advanced cervical cancer show that excellent treatment outcomes can be achieved with MRI-based IGABT, as well as acceptable late morbidity.</description><identifier>ISSN: 0179-7158</identifier><identifier>EISSN: 1439-099X</identifier><identifier>DOI: 10.1007/s00066-021-01887-x</identifier><identifier>PMID: 35059759</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cancer ; Cervical cancer ; Clinical outcomes ; Magnetic resonance imaging ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Radiation therapy ; Radiotherapy ; Toxicity</subject><ispartof>Strahlentherapie und Onkologie, 2022-09, Vol.198 (9), p.783-791</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c305t-1fdfa38d34439fc66c650e8572639d309e9b4a7c99e56ca8c053ee8559a2a90e3</citedby><cites>FETCH-LOGICAL-c305t-1fdfa38d34439fc66c650e8572639d309e9b4a7c99e56ca8c053ee8559a2a90e3</cites><orcidid>0000-0001-7318-7927</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00066-021-01887-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00066-021-01887-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35059759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vojtíšek, Radovan</creatorcontrib><creatorcontrib>Hošek, Petr</creatorcontrib><creatorcontrib>Sukovská, Emília</creatorcontrib><creatorcontrib>Kovářová, Petra</creatorcontrib><creatorcontrib>Baxa, Jan</creatorcontrib><creatorcontrib>Ferda, Jiří</creatorcontrib><creatorcontrib>Fínek, Jindřich</creatorcontrib><title>Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences</title><title>Strahlentherapie und Onkologie</title><addtitle>Strahlenther Onkol</addtitle><addtitle>Strahlenther Onkol</addtitle><description>Purpose
Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late toxicities, and dosimetric findings.
Methods
Between May 2012 and October 2020, we performed a total of 544 uterovaginal IGABT applications in 131 consecutive patients with biopsy-proven cervical carcinoma not suitable for surgery. The median duration of follow-up was 43 months.
Results
The estimated 3‑, 4‑, and 5‑year LC rates were 88.3% (95% confidence interval [CI] 81.1–95.5), 86.9% (95% CI 78.5–95.3), and 85.5% (95% CI 76–95%), respectively. The 3‑, 4‑, and 5‑year OS estimates were 72.66% (95% CI 63.64–81.69%), 68.9% (95% CI 59.15–78.66%), and 63.96% (95% CI 52.94–74.97%), respectively. Patients who received ≥ 5 cycles of chemotherapy had statistically significantly better 3‑year recurrence-free survival (RFS) compared to patients who completed <5 cycles (79.07% [95% CI 60.81–97.34] vs. 58.10% [95% CI 47.22–68.98];
p
= 0.0185). We recorded manifestations of genitourinary and gastrointestinal toxicity grade ≥3 in 6.9% and 5.3%, respectively.
Conclusion
Our mature long-term data on the treatment patients with locally advanced cervical cancer show that excellent treatment outcomes can be achieved with MRI-based IGABT, as well as acceptable late morbidity.</description><subject>Cancer</subject><subject>Cervical cancer</subject><subject>Clinical outcomes</subject><subject>Magnetic resonance imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Toxicity</subject><issn>0179-7158</issn><issn>1439-099X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9kc9rFDEUx4Modq3-Ax4k4MVL9GUyySTepGgtVAqlgreQzbzppswvk8y6e-8f3tRtFTx4Cnnv83kv4UvIaw7vOUDzIQGAUgwqzoBr3bDdE7LitTAMjPnxlKyAN4Y1XOoj8iKlGwCualM_J0dCgjSNNCtyexXR5QHHTKcl-2nARKeOfrs8Y9dLaLGlrnVzDluk6-j8Zp83GN28p2Gks8uhiIn-CnlD-8m7vt8XfutGX0SPcRtKjfr7e_xYlJRDXnKYxlLF3Yyx-B7TS_Ksc33CVw_nMfn-5fPVyVd2fnF6dvLpnHkBMjPetZ0TuhV1-WPnlfJKAmrZVEqYVoBBs65d441BqbzTHqTA0pfGVc4AimPy7jB3jtPPBVO2Q0ge-96NOC3JVqqqKs1rZQr69h_0ZlpieXehGpDacK7rQlUHyscppYidnWMYXNxbDvY-I3vIyJaM7O-M7K5Ibx5GL-sB2z_KYygFEAcgldZ4jfHv7v-MvQMpV5-o</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Vojtíšek, Radovan</creator><creator>Hošek, Petr</creator><creator>Sukovská, Emília</creator><creator>Kovářová, Petra</creator><creator>Baxa, Jan</creator><creator>Ferda, Jiří</creator><creator>Fínek, Jindřich</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7318-7927</orcidid></search><sort><creationdate>20220901</creationdate><title>Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences</title><author>Vojtíšek, Radovan ; Hošek, Petr ; Sukovská, Emília ; Kovářová, Petra ; Baxa, Jan ; Ferda, Jiří ; Fínek, Jindřich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-1fdfa38d34439fc66c650e8572639d309e9b4a7c99e56ca8c053ee8559a2a90e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cancer</topic><topic>Cervical cancer</topic><topic>Clinical outcomes</topic><topic>Magnetic resonance imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vojtíšek, Radovan</creatorcontrib><creatorcontrib>Hošek, Petr</creatorcontrib><creatorcontrib>Sukovská, Emília</creatorcontrib><creatorcontrib>Kovářová, Petra</creatorcontrib><creatorcontrib>Baxa, Jan</creatorcontrib><creatorcontrib>Ferda, Jiří</creatorcontrib><creatorcontrib>Fínek, Jindřich</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Strahlentherapie und Onkologie</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vojtíšek, Radovan</au><au>Hošek, Petr</au><au>Sukovská, Emília</au><au>Kovářová, Petra</au><au>Baxa, Jan</au><au>Ferda, Jiří</au><au>Fínek, Jindřich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences</atitle><jtitle>Strahlentherapie und Onkologie</jtitle><stitle>Strahlenther Onkol</stitle><addtitle>Strahlenther Onkol</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>198</volume><issue>9</issue><spage>783</spage><epage>791</epage><pages>783-791</pages><issn>0179-7158</issn><eissn>1439-099X</eissn><abstract>Purpose
Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late toxicities, and dosimetric findings.
Methods
Between May 2012 and October 2020, we performed a total of 544 uterovaginal IGABT applications in 131 consecutive patients with biopsy-proven cervical carcinoma not suitable for surgery. The median duration of follow-up was 43 months.
Results
The estimated 3‑, 4‑, and 5‑year LC rates were 88.3% (95% confidence interval [CI] 81.1–95.5), 86.9% (95% CI 78.5–95.3), and 85.5% (95% CI 76–95%), respectively. The 3‑, 4‑, and 5‑year OS estimates were 72.66% (95% CI 63.64–81.69%), 68.9% (95% CI 59.15–78.66%), and 63.96% (95% CI 52.94–74.97%), respectively. Patients who received ≥ 5 cycles of chemotherapy had statistically significantly better 3‑year recurrence-free survival (RFS) compared to patients who completed <5 cycles (79.07% [95% CI 60.81–97.34] vs. 58.10% [95% CI 47.22–68.98];
p
= 0.0185). We recorded manifestations of genitourinary and gastrointestinal toxicity grade ≥3 in 6.9% and 5.3%, respectively.
Conclusion
Our mature long-term data on the treatment patients with locally advanced cervical cancer show that excellent treatment outcomes can be achieved with MRI-based IGABT, as well as acceptable late morbidity.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35059759</pmid><doi>10.1007/s00066-021-01887-x</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-7318-7927</orcidid></addata></record> |
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| subjects | Cancer Cervical cancer Clinical outcomes Magnetic resonance imaging Medicine Medicine & Public Health Oncology Original Article Radiation therapy Radiotherapy Toxicity |
| title | Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences |
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