$High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes$
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High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes

Purpose: Brachytherapy (BT) boost after radio-chemotherapy (RCT) is a standard of care in the management of locally advanced cervical cancer (LACC). As there is no consensus on high-dose-rate (HDR) BT fractionation schemes, our aim was to report the oncological outcome and toxicity profile of four d...

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Autores principales:	Maud le Guyader, Daniel Lam Cham Kee, Brice Thamphya, Renaud Schiappa, Mathieu Gautier, Marie-Eve Chand-Fouche, Jean-Michel Hannoun-Levi
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Cervical cancer Brachytherapy High-dose-rate Fractionation scheme Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/29529ff497fa41c3bd5287d8155c5c6b
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spelling	oai:doaj.org-article:29529ff497fa41c3bd5287d8155c5c6b2021-11-12T04:42:20ZHigh-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes2405-630810.1016/j.ctro.2021.10.005https://doaj.org/article/29529ff497fa41c3bd5287d8155c5c6b2022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2405630821000902https://doaj.org/toc/2405-6308Purpose: Brachytherapy (BT) boost after radio-chemotherapy (RCT) is a standard of care in the management of locally advanced cervical cancer (LACC). As there is no consensus on high-dose-rate (HDR) BT fractionation schemes, our aim was to report the oncological outcome and toxicity profile of four different schemes using twice-a-day (BID) HDR-BT. Patients and methods: This was an observational, retrospective, single institution study for patients with LACC receiving a HDR-BT boost. The latter was performed with a single implant and single imaging done on day 1. The different fractionation schemes were: 7 Gy + 4x3.5 Gy (group 1); 7 Gy + 4x4.5 Gy (group 2); 3x7Gy (group 3) and 3x8Gy (group 4). Local (LFS), nodal (NFS) and metastatic (MFS) recurrence-free survival as well as progression-free survival (PFS) and overall survival (OS) were analyzed. Acute (≤6 months) and late toxicities (>6 months) were reported. Results: From 2007 to 2018, 191 patients were included. Median follow-up was 57 months [45–132] and median EQD210D90CTVHR was 84, 82 and 90 Gy for groups 2, 3 and 4 respectively (dosimetric data missing for group 1). The 5-year LFS, NFS, MFS, PFS and OS were 85% [81–90], 83% [79–86], 70% [67–73], 61% [57–64] and 75% [69–78] respectively, with no significant difference between the groups. EQD210D90CTVHR < 85 Gy was a prognostic factor for local recurrence in univariate analysis (p = 0.045). The rates of acute/late grade ≥ 2 urinary, digestive and gynecological toxicities were 9%/15%, 3%/15% and 9%/25% respectively. Conclusion: Bi-fractionated HDR-BT boost seems feasible with good oncological outcome and slightly more toxicity after dose escalation.Maud le GuyaderDaniel Lam Cham KeeBrice ThamphyaRenaud SchiappaMathieu GautierMarie-Eve Chand-FoucheJean-Michel Hannoun-LeviElsevierarticleCervical cancerBrachytherapyHigh-dose-rateFractionation schemeMedical physics. Medical radiology. Nuclear medicineR895-920Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENClinical and Translational Radiation Oncology, Vol 32, Iss , Pp 15-23 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cervical cancer Brachytherapy High-dose-rate Fractionation scheme Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Cervical cancer Brachytherapy High-dose-rate Fractionation scheme Medical physics. Medical radiology. Nuclear medicine R895-920 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Maud le Guyader Daniel Lam Cham Kee Brice Thamphya Renaud Schiappa Mathieu Gautier Marie-Eve Chand-Fouche Jean-Michel Hannoun-Levi High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes
description	Purpose: Brachytherapy (BT) boost after radio-chemotherapy (RCT) is a standard of care in the management of locally advanced cervical cancer (LACC). As there is no consensus on high-dose-rate (HDR) BT fractionation schemes, our aim was to report the oncological outcome and toxicity profile of four different schemes using twice-a-day (BID) HDR-BT. Patients and methods: This was an observational, retrospective, single institution study for patients with LACC receiving a HDR-BT boost. The latter was performed with a single implant and single imaging done on day 1. The different fractionation schemes were: 7 Gy + 4x3.5 Gy (group 1); 7 Gy + 4x4.5 Gy (group 2); 3x7Gy (group 3) and 3x8Gy (group 4). Local (LFS), nodal (NFS) and metastatic (MFS) recurrence-free survival as well as progression-free survival (PFS) and overall survival (OS) were analyzed. Acute (≤6 months) and late toxicities (>6 months) were reported. Results: From 2007 to 2018, 191 patients were included. Median follow-up was 57 months [45–132] and median EQD210D90CTVHR was 84, 82 and 90 Gy for groups 2, 3 and 4 respectively (dosimetric data missing for group 1). The 5-year LFS, NFS, MFS, PFS and OS were 85% [81–90], 83% [79–86], 70% [67–73], 61% [57–64] and 75% [69–78] respectively, with no significant difference between the groups. EQD210D90CTVHR < 85 Gy was a prognostic factor for local recurrence in univariate analysis (p = 0.045). The rates of acute/late grade ≥ 2 urinary, digestive and gynecological toxicities were 9%/15%, 3%/15% and 9%/25% respectively. Conclusion: Bi-fractionated HDR-BT boost seems feasible with good oncological outcome and slightly more toxicity after dose escalation.
format	article
author	Maud le Guyader Daniel Lam Cham Kee Brice Thamphya Renaud Schiappa Mathieu Gautier Marie-Eve Chand-Fouche Jean-Michel Hannoun-Levi
author_facet	Maud le Guyader Daniel Lam Cham Kee Brice Thamphya Renaud Schiappa Mathieu Gautier Marie-Eve Chand-Fouche Jean-Michel Hannoun-Levi
author_sort	Maud le Guyader
title	High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes
title_short	High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes
title_full	High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes
title_fullStr	High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes
title_full_unstemmed	High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes
title_sort	high-dose-rate brachytherapy boost for locally advanced cervical cancer: oncological outcome and toxicity analysis of 4 fractionation schemes
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/29529ff497fa41c3bd5287d8155c5c6b
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High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes

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