Ayşe Nur DEMİRAL

395

Effects of Image-Guided Adaptive Brachytherapy on Morbidity and Quality of Life in Cervical Cancer

Effects of Image-Guided Adaptive Brachytherapy on Morbidity and Quality of Life in Cervical Cancer

Image-guided adaptive brachytherapy (IGABT) is a technique now applied in locally advanced cervical cancer. This technique, in which magnetic resonance imaging is used prior to and during brachytherapy application, has led to important advances in gynecological brachytherapy, in terms of both dosimetric and clinical results. The reasons for using IGABT in cervical cancer include capacity of external radiotherapy to significantly shrink tumor prior to brachytherapy, high internal organ motion of cervix due to factors such as filling of urinary bladder, etc., and low local control rate in large tumors using 2-dimensional brachytherapy. In the last 20 years, there has been an increase in the success of treatment of cervical cancer with concomitant chemoradiotherapy and widespread use of IGABT. According to the results of major series using IGABT in cervical cancer, incidence of serious side effects is lower than 10%, and local control is in the range of 79% to 95%. Clinical results of IGABT studies have recommended organ at risk (OAR) dose parameters and limitations, and offered specific OAR (rectum, sigmoid, urinary bladder, bowel, vagina, urethra) toxicity measures and predictive dose-volume parameters. Studies have also provided review of this modality's impact on quality of life. Cancer patients must be informed about conditions they may confront after therapy and be offered detailed consultation and support regarding how to arrange their business, family, and social lives.
PDF

___

  • 1. Haie-Meder C, Pötter R, Van Limbergen E, Briot E, De Brabandere M, Dimopoulos J, et al; Gynaecological (GYN) GEC-ESTRO Working Group. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol 2005;74(3):235-45
  • 2. Lindegaard JC, Tanderup K, Nielsen SK, Haack S, Gelineck J. MRI-guided 3D optimization significantly improves DVH parameters of pulsed-dose-rate brachytherapy in locally advanced cervical cancer. Int J Radiat Oncol Biol Phys 2008;71(3):756-64.
  • 3. Pötter R, Dimopoulos J, Georg P, Lang S, Waldhäusl C, Wachter-Gerstner N, et al. Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer. Radiother Oncol 2007;83(2):148-55.
  • 4. Potter R, Kirisits C, Fidarova EF, Dimopoulos JC, Berger D, Tanderup K, et al. Present status and future of high-precision image guided adaptive brachytherapy for cervix carcinoma. Acta Oncol 2008;47(7):1325- 36.
  • 5. Pötter R, Georg P, Dimopoulos JC, Grimm M, Berger D, Nesvacil N, et al. Clinical outcome of protocol based image (MRI) guided adaptive brachytherapy combined with 3D conformal radiotherapy with or without chemotherapy in patients with locally advanced cervical cancer. Radiother Oncol 2011;100(1):116-23.
  • 6. Lindegaard JC, Fokdal LU, Nielsen SK, Juul-Christensen J, Tanderup K. MRI-guided adaptive radiotherapy in locally advanced cervical cancer from a Nordic perspective. Acta Oncol 2013;52(7):1510-9.
  • 7. Mazeron R, Gilmore J, Dumas I, Champoudry J, Goulart J, Vanneste B, et al. Adaptive 3D image-guided brachytherapy: a strong argument in the debate on systematic radical hysterectomy for locally advanced cervical cancer. Oncologist 2013;18(4):415-22.
  • 8. Nomden CN, de Leeuw AA, Roesink JM, Tersteeg RJ, Moerland MA, Witteveen PO, et al. Clinical outcome and dosimetric parameters of chemo-radiation including MRI guided adaptive brachytherapy with tandem-ovoid applicators for cervical cancer patients: a single institution experience. Radiother Oncol 2013;107(1):69-74.
  • 9. Rijkmans EC, Nout RA, Rutten IH, Ketelaars M, Neelis KJ, Laman MS, et al. Improved survival of patients with cervical cancer treated with image-guided brachytherapy compared with conventional brachytherapy. Gynecol Oncol 2014;135(2):231-8.
  • 10.Lakosi F, de Cuypere M, Viet Nguyen P, Jansen N, Warlimont B, Gulyban A, et al. Clinical efficacy and toxicity of radio-chemotherapy and magnetic resonance imaging-guided brachytherapy for locally advanced cervical cancer patients: A mono-institutional experience. Acta Oncol 2015;54(9):1558-66.
  • 11.Castelnau-Marchand P, Chargari C, Maroun P, Dumas I, Del Campo ER, Cao K, et al. Clinical outcomes of definitive chemoradiation followed by intracavitary pulsed-dose rate image-guided adaptive brachytherapy in locally advanced cervical cancer. Gynecol Oncol 2015;139(2):288-94.
  • 12.Gill BS, Kim H, Houser CJ, Kelley JL, Sukumvanich P, Edwards RP, et al. MRI-guided high-dose-rate intracavitary brachytherapy for treatment of cervical cancer: the University of Pittsburgh experience. Int J Radiat Oncol Biol Phys 2015;91(3):540-7.
  • 13.Charra-Brunaud C, Harter V, Delannes M, Haie-Meder C, Quetin P, Kerr C, et al. Impact of 3D image-based PDR brachytherapy on outcome of patients treated for cervix carcinoma in France: results of the French STIC prospective study. Radiother Oncol 2012;103(3):305- 13.
  • 14.ICRU Report 89. Journal of ICRU 2013;13(1- 2). Available at: https://academic.oup.com/jicru/article-abstract/13/1-2/NP/2379433/Report- 89?redirectedFrom=fulltext. Accessed Jun 14, 2017.
  • 15.Harkenrider MM, Alite F, Silva SR, Small W Jr. ImageBased Brachytherapy for the Treatment of Cervical Cancer. Int J Radiat Oncol Biol Phys 2015;92(4):921- 34.
  • 16.Mazeron R, Maroun P, Castelnau-Marchand P, Dumas I, del Campo ER, Cao K, et al. Pulsed-dose rate image-guided adaptive brachytherapy in cervical cancer: Dose-volume effect relationships for the rectum and bladder. Radiother Oncol 2015;116(2):226-32.
  • 17.Georg P, Boni A, Ghabuous A, Goldner G, Schmid MP, Georg D, et al. Time course of late rectal- and urinary bladder side effects after MRI-guided adaptive brachytherapy for cervical cancer. Strahlenther Onkol 2013;189(7):535-40.
  • 18.Ribeiro I, Janssen H, De Brabandere M, Nulens A, De Bal D, Vergote I, et al. Long term experience with 3D image guided brachytherapy and clinical outcome in cervical cancer patients. Radiother Oncol 2016;120(3):447-54.
  • 19.Georg P, Lang S, Dimopoulos JC, Dörr W, Sturdza AE, Berger D, et al. Dose-volume histogram parameters and late side effects in magnetic resonance imageguided adaptive cervical cancer brachytherapy. Int J Radiat Oncol Biol Phys 2011;79(2):356-62.
  • 20.Sturdza A, Pötter R, Fokdal LU, Haie-Meder C, Tan LT, Mazeron R, et al. Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study. Radiother Oncol 2016;120(3):428-33.
  • 21.Mazeron R, Dumas I, Rivin E, Martin V, BenhabibBoukhelif W, Tailleur A, et al. D2cm³/DICRU ratio as a surrogate of bladder hotspots localizations during image-guided adaptive brachytherapy for cervical cancer: assessment and implications in late urinary morbidity analysis. Brachytherapy 2015;14(2):300-7.
  • 22.Petit C, Dumas I, Chargari C, Martinetti F, Maroun P, Doyeux K, et al. MRI-guided brachytherapy in locally advanced cervical cancer: Small bowel D0.1cc and D2cc are not predictive of late morbidity. Brachytherapy 2016;15(4):463-70.
  • 23.Hauer-Jensen M, Denham JW, Andreyev HJ. Radiation enteropathy-pathogenesis, treatment and prevention. Nat Rev Gastroenterol Hepatol 2014;11(8):470- 9.
  • 24.Mouttet-Audouard R, Lacornerie T, Tresch E, Kramar A, Le Tinier F, Reynaert N, et al. What is the normal tissues morbidity following Helical Intensity Modulated Radiation Treatment for cervical cancer? Radiother Oncol 2015;115(3):386-91.
  • 25.Kirchheiner K, Nout RA, Tanderup K, Lindegaard JC, Westerveld H, Haie-Meder C, et al. Manifestation pattern of early-late vaginal morbidity after definitive radiation (chemo)therapy and image-guided adaptive brachytherapy for locally advanced cervical cancer: an analysis from the EMBRACE study. Int J Radiat Oncol Biol Phys 2014;89(1):88-95.
  • 26.Rai B, Dhanireddy B, Patel FD, Kumari R, Oinam AS, Simha V, et al. Vaginal dose, toxicity and sexual outcomes in patients of cervical cancer undergoing image based brachytherapy. Asian Pac J Cancer Prev 2014;15(8):3619-23.
  • 27.Fidarova EF, Berger D, Schüssler S, Dimopoulos J, Kirisits C, Georg P, et al. Dose volume parameter D2cc does not correlate with vaginal side effects in individual patients with cervical cancer treated within a defined treatment protocol with very high brachytherapy doses. Radiother Oncol 2010;97(1):76-9.
  • 28.Susko M, Craciunescu O, Meltsner S, Yang Y, Steffey B, Cai J, et al. Vaginal Dose Is Associated With Toxicity in Image Guided Tandem Ring or Ovoid-Based Brachytherapy. Int J Radiat Oncol Biol Phys 2016;94(5):1099- 105.
  • 29.Kirchheiner K, Nout RA, Lindegaard JC, Haie-Meder C, Mahantshetty U, Segedin B, et al. Dose-effect relationship and risk factors for vaginal stenosis after definitive radio(chemo)therapy with image-guided brachytherapy for locally advanced cervical cancer in the EMBRACE study. Radiother Oncol 2016;118(1):160-6.
  • 30.Dimopoulos JC, Schmid MP, Fidarova E, Berger D, Kirisits C, Pötter R. Treatment of locally advanced vaginal cancer with radiochemotherapy and magnetic resonance image-guided adaptive brachytherapy: dose-volume parameters and first clinical results. Int J Radiat Oncol Biol Phys 2012;82(5):1880-8.
  • 31.Kirchheiner K, Nout RA, Czajka-Pepl A, PonocnySeliger E, Sturdza AE, Dimopoulos JC, et al. Health related quality of life and patient reported symptoms before and during definitive radio(chemo)therapy using image-guided adaptive brachytherapy for locally advanced cervical cancer and early recovery - a mono-institutional prospective study. Gynecol Oncol 2015;136(3):415-23.
  • 32.Kirchheiner K, Pötter R, Tanderup K, Lindegaard JC, Haie-Meder C, Petric P, et al. Health-Related Quality of Life in Locally Advanced Cervical Cancer Patients After Definitive Chemoradiation Therapy Including Image Guided Adaptive Brachytherapy: An Analysis From the EMBRACE Study. Int J Radiat Oncol Biol Phys 2016;94(5):1088-98.
Türk Onkoloji Dergisi-Cover
  • ISSN: 1300-7467
  • Başlangıç: 2015
  • Yayıncı: Ali Cangül
Arşiv
Sayıdaki Diğer Makaleler

Dosimetric Comparison of Static Field Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy for Adjuvant Treatment of Patients with Endometrial Cancer

Songül KARACAM, Ismet ŞAHINLER, Gülyüz ATKOVAR, Şefika Arzu ERGEN, Olgun ELICIN, Servet IPEK

Effects of Image-Guided Adaptive Brachytherapy on Morbidity and Quality of Life in Cervical Cancer

Ayşe Nur DEMİRAL

Cancer Incidence 2010-2014 Among the North Cyprus Population of Adults Aged 15 and Over

Evren HINÇAL, Deniz GRANIT, Nuriye SANCAR, Meltem NALÇA ANDRIEU

Volumetric Arc Therapy Seems More Promising for Sparing Organs at Risk in Adjuvant Postoperative Radiotherapy for Pancreatic Adenocarcinoma than Step-and-Shoot Intensity-Modulated Radiotherapy

Uğur SELEK, Duygu SEZEN, Yasemin BÖLÜKBAŞI, Yücel SAĞLAM, Z. Vildan ALPAN, Steve KIRSNER

Challenges Experienced by and Quality of Life of Relatives of Cancer Patients Requiring Palliative Care at Home

Medine YILMAZ, Cihan GÜLTAŞ