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Improved survival of patients with cervical cancer treated with image-guided brachytherapy compared with conventional brachytherapy.
Rijkmans, E C; Nout, R A; Rutten, I H H M; Ketelaars, M; Neelis, K J; Laman, M S; Coen, V L M A; Gaarenstroom, K N; Kroep, J R; Creutzberg, C L.
Afiliación
  • Rijkmans EC; Department of Clinical Oncology, Subdivision of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Nout RA; Department of Clinical Oncology, Subdivision of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Rutten IH; Department of Clinical Oncology, Subdivision of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Ketelaars M; Department of Clinical Oncology, Subdivision of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Neelis KJ; Department of Clinical Oncology, Subdivision of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Laman MS; Department of Clinical Oncology, Subdivision of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Coen VL; Zeeuws Radiotherapy Institute, Vlissingen, The Netherlands.
  • Gaarenstroom KN; Department of Gynecology and Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
  • Kroep JR; Department of Clinical Oncology, Subdivision of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
  • Creutzberg CL; Department of Clinical Oncology, Subdivision of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: c.l.creutzberg@lumc.nl.
Gynecol Oncol ; 135(2): 231-8, 2014 Nov.
Article en En | MEDLINE | ID: mdl-25172763
OBJECTIVE: Since the Group Européen de Curiethérapie and the European Society for Radiotherapy and Oncology (GEC-ESTRO) published recommendations for 3D MRI-based image-guided adaptive brachytherapy (IGBT) in the treatment of cervical cancer, many institutions have implemented this technique and favourable results were documented. We investigated if introduction of IGBT in our centre indeed improved treatment outcomes and reduced toxicity compared to conventional brachytherapy (CBT). METHODS: A retrospective analysis was done of outcomes of patients with stage IB-IVA cervical cancer treated with primary radiation therapy with curative intent between 2000 and 2012. Outcome measures were overall and disease-free survival, pelvic control, distant metastasis and treatment related adverse events (AE). RESULTS: 126 patients were analysed; 43 had been treated with CBT between 2000-2007, and 83 with IGBT between 2007-2012. External beam radiation (mean; 46.6Gy) was combined with concurrent weekly cisplatin (51.6%), or hyperthermia (24.6%); radiation alone was used in 23.8%. Median follow-up was 121.8months for CBT patients, vs. 42.3months for IGBT. Complete remission was achieved in 83.7% of patients in the CBT group and in 98.8% of IGBT patients (p<0.01). Overall survival at 3years was 51% and 86%, respectively (p=0.001). Pelvic recurrence was found in 32% vs. 7% (p<0.001). Most patients had low grade adverse events. High grade (3-4) AE occurred in 15.4% vs. 8.4% at 3years (p=0.06). CONCLUSION: Introduction of IGBT for cervical cancer has led to significantly increased 3-year locoregional control and survival rates, whilst reducing late morbidity.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Braquiterapia / Carcinoma de Células Escamosas / Adenocarcinoma / Neoplasias del Cuello Uterino / Carcinoma Adenoescamoso / Radioterapia Guiada por Imagen / Recurrencia Local de Neoplasia Tipo de estudio: Guideline / Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Gynecol Oncol Año: 2014 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Braquiterapia / Carcinoma de Células Escamosas / Adenocarcinoma / Neoplasias del Cuello Uterino / Carcinoma Adenoescamoso / Radioterapia Guiada por Imagen / Recurrencia Local de Neoplasia Tipo de estudio: Guideline / Observational_studies Límite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Gynecol Oncol Año: 2014 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos