Clinical outcomes of MRI-guided adaptive brachytherapy for each fraction in locally advanced cervical cancer: a single institution experience
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Authors
Chi, Yunbo
Pan, Ying
Zhang, Ning
Han, Dongmei
Guo, Xin
Mao, Zhuang
Cheng, Guanghui
Issue Date
2022-03-17
Type
Article
Language
en_US
Keywords
Locally Advanced Cervical Cancer , Magnetic Resonance Imaging Guided Adaptive Brachytherapy , Intracavitary Brachytherapy , Interstitial Brachytherapy , Hybrid Intracavitary/Interstitial Brachytherapy , Clinical Outcomes
Alternative Title
Abstract
Purpose:
This study aims to evaluate clinical outcomes of MRI-guided adaptive brachytherapy (MR-IGABT) for each brachytherapy fraction in patients with locally advanced cervical cancer (LACC).
Methods and Materials:
A retrospective analysis was performed on 97 consecutive patients with LACC treated with 44.0–50.4 Gy external beam radiotherapy (EBRT) ± concurrent platinum-containing chemotherapy followed by 4 × 7 Gy MR-IGABT between September 2014 and April 2019. Intracavitary (IC)/interstitial (IS)/hybrid intracavitary and interstitial (IC/IS) brachytherapy was used in MR-IGABT. Brachytherapy planning and dose reporting followed the GEC-ESTRO recommendations. Clinical outcomes including overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), local control (LC), and treatment-related toxicity evaluated by the RTOG criteria were analyzed. Kaplan–Meier and univariable and multivariable Cox regression analyses were used to analyze the prognostic factor.
Results:
Median follow-up was 21.1 months. Median dose to 90% (D90) of the high-risk clinical target volume (HR-CTV) was 91.7 Gy (range 76.7~107.2 Gy). Two-year OS, CSS, PFS, and LC were 83.5%, 84.1%, 71.1%, and 94.8%, respectively. Four patients (4.1%) suffered from grade 3 late gastrointestinal radiation toxicity, and no other grade 3 or greater radiation toxicity occurred. Initial HR-CTV was an independent factor of OS (p = 0.001, HR = 1.018/cm3), PFS (p = 0.012, HR = 1.012/cm3), and LC (p = 0.011, HR = 1.028/cm3). The HR-CTV D90 (p = 0.044, HR = 0.923/Gy) was an independent factor of PFS. Age was an independent factor of LC (p = 0.010, HR = 1.111/year).
Conclusion:
For patients with LACC, MR-IGABT was effective and safe. It showed favorable LC, OS, and minimal toxicity. Moreover, initial HR-CTV, HR-CTV D90, and age were significant prognostic factors.
Description
Citation
Chi, Y., Pan, Y., Zhang, N., Han, D., Guo, X., Mao, Z., & Cheng, G. (2022). Clinical Outcomes of MRI-Guided Adaptive Brachytherapy for Each Fraction in Locally Advanced Cervical Cancer: A Single Institution Experience. Frontiers in oncology, 12, 841980. https://doi.org/10.3389/fonc.2022.841980
Publisher
Frontiers in Oncology