Clinical Outcome Comparison between CT-Guided Versus all MRI-Guided Scenarios in Brachytherapy for Cervical Cancer: A Single-Institute Experience
Image-guided adaptive brachytherapy (IGABT) is the standard of care for patients with cervical cancer. The objective of this study was to compare the treatment outcomes and adverse effects of computed tomography (CT)-guided and magnetic resonance imaging (MRI)-guided scenarios. Data of patients with...
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| Veröffentlicht in: | Clinical oncology (Royal College of Radiologists (Great Britain)) 2024-11, Vol.36 (11), p.e456-e467 |
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| creator | Dankulchai, P. Prasartseree, T. Sittiwong, W. Chansilpa, Y. Apiwarodom, N. Petsuksiri, J. Thephamongkhol, K. Treechairusame, T. Jitwatcharakomol, T. Setakornnukul, J. Teyateeti, A. Rongthong, W. Thaweerat, W. Suntornpong, N. Veerasarn, V. Tuntapakul, P. Chareonsiriwat, N. Manopetchkasem, S. |
| description | Image-guided adaptive brachytherapy (IGABT) is the standard of care for patients with cervical cancer. The objective of this study was to compare the treatment outcomes and adverse effects of computed tomography (CT)-guided and magnetic resonance imaging (MRI)-guided scenarios.
Data of patients with cervical cancer treated using external beam radiotherapy followed by IGABT from 2012 to 2016 were retrospectively reviewed. CT-guided IGABT was compared with the three modes of MRI-guided IGABT: pre-brachytherapy (MRI Pre-BT) without applicator insertion for fusion, planning MRI with applicator in-place in at least 1 fraction (MRI ≥1Fx), and MRI in every fraction (MRI EveryFx). Patient characteristics, oncologic outcomes, and late radiation toxicity were analyzed using descriptive, survival, and correlation statistics.
Overall, 354 patients were evaluated with a median follow-up of 60 months. The 5-year overall survival (OS) rates were 61.5%, 65.2%, 54.4%, and 63.7% with CT-guided, MRI PreBT, MRI ≥1Fx, and MRI EveryFx IGABT, respectively with no significant differences (p = 0.522). The 5-year local control (LC) rates were 92.1%, 87.8%, 80.7%, and 76.5% (p = 0.133), respectively, with a significant difference observed between the CT-guided and MRI ≥1Fx (p = 0.018). The grade 3–4 late gastrointestinal toxicity rates were 6% in the CT-guided, MRI ≥1Fx, and MRI EveryFx, and 8% in MRI PreBT. The grade 3–4 late genitourinary toxicity rates were 4% in the CT-guided, 2% in MRI PreBT, 1% in MRI ≥1Fx, and none in MRI EveryFx. No significant differences were observed in the oncologic and toxicity outcomes among MRI PreBT, MRI ≥1Fx, and MRI EveryFx.
CT-guided IGABT yielded an acceptable 5-year OS, LC, and toxicity profile compared with all MRI scenarios and is a potentially feasible option in resource-limited settings.
•CT-only IGABT was comparable to all MRI-guided scenarios.•No significant differences established among MRI Pre-BT, MRI ≥1Fx, and MRI EveryFx.•Utility of CT and MRI could be personalised based on availability of resources. |
| doi_str_mv | 10.1016/j.clon.2024.08.003 |
| format | Article |
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Data of patients with cervical cancer treated using external beam radiotherapy followed by IGABT from 2012 to 2016 were retrospectively reviewed. CT-guided IGABT was compared with the three modes of MRI-guided IGABT: pre-brachytherapy (MRI Pre-BT) without applicator insertion for fusion, planning MRI with applicator in-place in at least 1 fraction (MRI ≥1Fx), and MRI in every fraction (MRI EveryFx). Patient characteristics, oncologic outcomes, and late radiation toxicity were analyzed using descriptive, survival, and correlation statistics.
Overall, 354 patients were evaluated with a median follow-up of 60 months. The 5-year overall survival (OS) rates were 61.5%, 65.2%, 54.4%, and 63.7% with CT-guided, MRI PreBT, MRI ≥1Fx, and MRI EveryFx IGABT, respectively with no significant differences (p = 0.522). The 5-year local control (LC) rates were 92.1%, 87.8%, 80.7%, and 76.5% (p = 0.133), respectively, with a significant difference observed between the CT-guided and MRI ≥1Fx (p = 0.018). The grade 3–4 late gastrointestinal toxicity rates were 6% in the CT-guided, MRI ≥1Fx, and MRI EveryFx, and 8% in MRI PreBT. The grade 3–4 late genitourinary toxicity rates were 4% in the CT-guided, 2% in MRI PreBT, 1% in MRI ≥1Fx, and none in MRI EveryFx. No significant differences were observed in the oncologic and toxicity outcomes among MRI PreBT, MRI ≥1Fx, and MRI EveryFx.
CT-guided IGABT yielded an acceptable 5-year OS, LC, and toxicity profile compared with all MRI scenarios and is a potentially feasible option in resource-limited settings.
•CT-only IGABT was comparable to all MRI-guided scenarios.•No significant differences established among MRI Pre-BT, MRI ≥1Fx, and MRI EveryFx.•Utility of CT and MRI could be personalised based on availability of resources.</description><identifier>ISSN: 0936-6555</identifier><identifier>ISSN: 1433-2981</identifier><identifier>EISSN: 1433-2981</identifier><identifier>DOI: 10.1016/j.clon.2024.08.003</identifier><identifier>PMID: 39218741</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Cervical cancer ; CT-guided IGABT ; High dose rate ; Image guided adaptive brachytherapy (HDR-IGABT) ; MRI-guided IGABT</subject><ispartof>Clinical oncology (Royal College of Radiologists (Great Britain)), 2024-11, Vol.36 (11), p.e456-e467</ispartof><rights>2024 The Royal College of Radiologists</rights><rights>Copyright © 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-dd22e8aeeffba110cbfb1f763776556112d2f667a2d4e1701b9b8f096662b9d43</cites><orcidid>0000-0003-1697-905X ; 0000-0001-5421-4248 ; 0000-0001-6957-8861 ; 0000-0002-0998-8874 ; 0000-0003-0334-2551 ; 0000-0002-2731-9500</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.clon.2024.08.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39218741$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dankulchai, P.</creatorcontrib><creatorcontrib>Prasartseree, T.</creatorcontrib><creatorcontrib>Sittiwong, W.</creatorcontrib><creatorcontrib>Chansilpa, Y.</creatorcontrib><creatorcontrib>Apiwarodom, N.</creatorcontrib><creatorcontrib>Petsuksiri, J.</creatorcontrib><creatorcontrib>Thephamongkhol, K.</creatorcontrib><creatorcontrib>Treechairusame, T.</creatorcontrib><creatorcontrib>Jitwatcharakomol, T.</creatorcontrib><creatorcontrib>Setakornnukul, J.</creatorcontrib><creatorcontrib>Teyateeti, A.</creatorcontrib><creatorcontrib>Rongthong, W.</creatorcontrib><creatorcontrib>Thaweerat, W.</creatorcontrib><creatorcontrib>Suntornpong, N.</creatorcontrib><creatorcontrib>Veerasarn, V.</creatorcontrib><creatorcontrib>Tuntapakul, P.</creatorcontrib><creatorcontrib>Chareonsiriwat, N.</creatorcontrib><creatorcontrib>Manopetchkasem, S.</creatorcontrib><title>Clinical Outcome Comparison between CT-Guided Versus all MRI-Guided Scenarios in Brachytherapy for Cervical Cancer: A Single-Institute Experience</title><title>Clinical oncology (Royal College of Radiologists (Great Britain))</title><addtitle>Clin Oncol (R Coll Radiol)</addtitle><description>Image-guided adaptive brachytherapy (IGABT) is the standard of care for patients with cervical cancer. The objective of this study was to compare the treatment outcomes and adverse effects of computed tomography (CT)-guided and magnetic resonance imaging (MRI)-guided scenarios.
Data of patients with cervical cancer treated using external beam radiotherapy followed by IGABT from 2012 to 2016 were retrospectively reviewed. CT-guided IGABT was compared with the three modes of MRI-guided IGABT: pre-brachytherapy (MRI Pre-BT) without applicator insertion for fusion, planning MRI with applicator in-place in at least 1 fraction (MRI ≥1Fx), and MRI in every fraction (MRI EveryFx). Patient characteristics, oncologic outcomes, and late radiation toxicity were analyzed using descriptive, survival, and correlation statistics.
Overall, 354 patients were evaluated with a median follow-up of 60 months. The 5-year overall survival (OS) rates were 61.5%, 65.2%, 54.4%, and 63.7% with CT-guided, MRI PreBT, MRI ≥1Fx, and MRI EveryFx IGABT, respectively with no significant differences (p = 0.522). The 5-year local control (LC) rates were 92.1%, 87.8%, 80.7%, and 76.5% (p = 0.133), respectively, with a significant difference observed between the CT-guided and MRI ≥1Fx (p = 0.018). The grade 3–4 late gastrointestinal toxicity rates were 6% in the CT-guided, MRI ≥1Fx, and MRI EveryFx, and 8% in MRI PreBT. The grade 3–4 late genitourinary toxicity rates were 4% in the CT-guided, 2% in MRI PreBT, 1% in MRI ≥1Fx, and none in MRI EveryFx. No significant differences were observed in the oncologic and toxicity outcomes among MRI PreBT, MRI ≥1Fx, and MRI EveryFx.
CT-guided IGABT yielded an acceptable 5-year OS, LC, and toxicity profile compared with all MRI scenarios and is a potentially feasible option in resource-limited settings.
•CT-only IGABT was comparable to all MRI-guided scenarios.•No significant differences established among MRI Pre-BT, MRI ≥1Fx, and MRI EveryFx.•Utility of CT and MRI could be personalised based on availability of resources.</description><subject>Cervical cancer</subject><subject>CT-guided IGABT</subject><subject>High dose rate</subject><subject>Image guided adaptive brachytherapy (HDR-IGABT)</subject><subject>MRI-guided IGABT</subject><issn>0936-6555</issn><issn>1433-2981</issn><issn>1433-2981</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9UcFu1DAUtBAV3S78AAfkI5ektpM4MeJSorasVFSJFq6WYz9TrxI72Enpfkb_mGy35cjpSe_NzNPMIPSekpwSyk-3ue6DzxlhZU6anJDiFVrRsigyJhr6Gq2IKHjGq6o6RicpbQkhrGnEG3RcCEabuqQr9Nj2zjutenw9TzoMgNswjCq6FDzuYPoD4HF7m13OzoDBPyGmOWHV9_jb983L9kaDXyghYefxl6j03W66g6jGHbYh4hbi_dOLVnkN8RM-wzfO_-oh2_g0uWmeAJ8_jBAdLPe36MiqPsG757lGPy7Ob9uv2dX15aY9u8o0K-opM4YxaBSAtZ2ilOjOdtTWvKjrxTGnlBlmOa8VMyXQmtBOdI0lgnPOOmHKYo0-HnTHGH7PkCY5uKSh75WHMCdZECGaildLnmvEDlAdQ0oRrByjG1TcSUrkvgq5lfsq5L4KSRq5VLGQPjzrz90A5h_lJfsF8PkAgMXlvYMok35KwLgIepImuP_p_wWXBpvs</recordid><startdate>20241101</startdate><enddate>20241101</enddate><creator>Dankulchai, P.</creator><creator>Prasartseree, T.</creator><creator>Sittiwong, W.</creator><creator>Chansilpa, Y.</creator><creator>Apiwarodom, N.</creator><creator>Petsuksiri, J.</creator><creator>Thephamongkhol, K.</creator><creator>Treechairusame, T.</creator><creator>Jitwatcharakomol, T.</creator><creator>Setakornnukul, J.</creator><creator>Teyateeti, A.</creator><creator>Rongthong, W.</creator><creator>Thaweerat, W.</creator><creator>Suntornpong, N.</creator><creator>Veerasarn, V.</creator><creator>Tuntapakul, P.</creator><creator>Chareonsiriwat, N.</creator><creator>Manopetchkasem, S.</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1697-905X</orcidid><orcidid>https://orcid.org/0000-0001-5421-4248</orcidid><orcidid>https://orcid.org/0000-0001-6957-8861</orcidid><orcidid>https://orcid.org/0000-0002-0998-8874</orcidid><orcidid>https://orcid.org/0000-0003-0334-2551</orcidid><orcidid>https://orcid.org/0000-0002-2731-9500</orcidid></search><sort><creationdate>20241101</creationdate><title>Clinical Outcome Comparison between CT-Guided Versus all MRI-Guided Scenarios in Brachytherapy for Cervical Cancer: A Single-Institute Experience</title><author>Dankulchai, P. ; 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The objective of this study was to compare the treatment outcomes and adverse effects of computed tomography (CT)-guided and magnetic resonance imaging (MRI)-guided scenarios.
Data of patients with cervical cancer treated using external beam radiotherapy followed by IGABT from 2012 to 2016 were retrospectively reviewed. CT-guided IGABT was compared with the three modes of MRI-guided IGABT: pre-brachytherapy (MRI Pre-BT) without applicator insertion for fusion, planning MRI with applicator in-place in at least 1 fraction (MRI ≥1Fx), and MRI in every fraction (MRI EveryFx). Patient characteristics, oncologic outcomes, and late radiation toxicity were analyzed using descriptive, survival, and correlation statistics.
Overall, 354 patients were evaluated with a median follow-up of 60 months. The 5-year overall survival (OS) rates were 61.5%, 65.2%, 54.4%, and 63.7% with CT-guided, MRI PreBT, MRI ≥1Fx, and MRI EveryFx IGABT, respectively with no significant differences (p = 0.522). The 5-year local control (LC) rates were 92.1%, 87.8%, 80.7%, and 76.5% (p = 0.133), respectively, with a significant difference observed between the CT-guided and MRI ≥1Fx (p = 0.018). The grade 3–4 late gastrointestinal toxicity rates were 6% in the CT-guided, MRI ≥1Fx, and MRI EveryFx, and 8% in MRI PreBT. The grade 3–4 late genitourinary toxicity rates were 4% in the CT-guided, 2% in MRI PreBT, 1% in MRI ≥1Fx, and none in MRI EveryFx. No significant differences were observed in the oncologic and toxicity outcomes among MRI PreBT, MRI ≥1Fx, and MRI EveryFx.
CT-guided IGABT yielded an acceptable 5-year OS, LC, and toxicity profile compared with all MRI scenarios and is a potentially feasible option in resource-limited settings.
•CT-only IGABT was comparable to all MRI-guided scenarios.•No significant differences established among MRI Pre-BT, MRI ≥1Fx, and MRI EveryFx.•Utility of CT and MRI could be personalised based on availability of resources.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>39218741</pmid><doi>10.1016/j.clon.2024.08.003</doi><orcidid>https://orcid.org/0000-0003-1697-905X</orcidid><orcidid>https://orcid.org/0000-0001-5421-4248</orcidid><orcidid>https://orcid.org/0000-0001-6957-8861</orcidid><orcidid>https://orcid.org/0000-0002-0998-8874</orcidid><orcidid>https://orcid.org/0000-0003-0334-2551</orcidid><orcidid>https://orcid.org/0000-0002-2731-9500</orcidid></addata></record> |
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| subjects | Cervical cancer CT-guided IGABT High dose rate Image guided adaptive brachytherapy (HDR-IGABT) MRI-guided IGABT |
| title | Clinical Outcome Comparison between CT-Guided Versus all MRI-Guided Scenarios in Brachytherapy for Cervical Cancer: A Single-Institute Experience |
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