Clinical outcomes from an innovative protocol using serial ultrasound imaging and a single MR image to guide brachytherapy for locally advanced cervix cancer

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• 作者：Sylvia van Dyk¹ ; ^{sylvia.vandyk@petermac.org} ; Kailash Narayan² ; ³ ; David Bernshaw² ; Srinivas Kondalsamy-Chennakesavan⁴ ; Pearly Khaw² ; Ming Yin Lin² ; Michal Schneider⁵
• 关键词：Brachytherapy ; Cervix cancer ; Ultrasound ; MRI
• 刊名：Brachytherapy
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：15
• 期：6
• 页码：817-824
• 全文大小：666 K
• 卷排序：15

文摘

The aim of this study was to report clinical outcomes in a series of patients who underwent serial ultrasound and a single MRI to plan and verify intracavitary brachytherapy.Methods and MaterialsData for patients who were referred for curative intent radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) Stage 1–1V cervix cancer between January 2007 and March 2012 were analyzed. All patients received external beam radiotherapy with concurrent chemotherapy and sequential high-dose rate brachytherapy. Brachytherapy was planned and verified using serial ultrasound imaging and a single MRI.ResultsData from 191 patients were available for analyses. The median (range) followup time was 5.08 (0.25–8.25) years. Five-year local control, failure-free survival, cancer-specific survival, and overall survival were 86%, 57.3%, 70% and 63%, respectively. Mean (standard deviation) combined external beam radiotherapy and brachytherapy target doses, equivalent to doses in 2 Gy fractions were 80.4 Gy10 (3.89), median (range) 80 (49–96) Gy10. Grade 3 or greater gastrointestinal, genitourinary, or vaginal late toxicity occurred in 3%, 1.6%, and 2% of patients, respectively. Survival, patterns of failure, and late complication rates were similar to published series of MRI/CT–based brachytherapy practices.ConclusionsThis large study demonstrates that favorable treatment outcomes can be obtained using a pragmatic and innovative combination of ultrasound and MR imaging.