Dear Authors,
If you believe that your paper was mistakenly rejected by other leading journals and you do not agree with final decision, the editors of Reports of Practical Oncology and Radiotherapy offer new fast track review. You may submit your manuscript to Reports of Practical Oncology and Radiotherapy together with all prior peer-reviews obtained from the other journal and your rebuttal letter. We guarantee review based decision within 72 hours from the time we will receive your manuscript.

Fast track submission process: Please submit the manuscript with all reviews and rebuttal letter by email to Dr. Michal Masternak (michal.masternak@ucf.edu) for fast review processing. To assure immediate attention the email title must to include: RPOR-fast track- Last Name First Name (of corresponding author).

Volume 23, Number 6, 2018

Image-guided brachytherapy in cervical cancer: Experience in the Complejo Hospitalario de Navarra

Elena Villafranca, Paola Navarrete, Amaya Sola, Juan Carlos Muruzabal, Marta Barrado

Summary:

Purpose To evaluate dosimetric and clinical findings of MRI-guided HDR brachytherapy (HDR-B) for cervical carcinoma. Material and methods All patients had a CT, MRI and pelvic-paraaortic lymphadenectomy. Treatment: pelvic (+/−)para-aortic3D/IMRT radiotherapy (45 Gy), weekly cisplatin and HDR-B and pelvic node/parametrial boost 60 Gy until interstitial brachytherapy was done. Two implants: 2008–2011: 5 fractions of 6 Gy, 2011: 2016, 4 fractions of 7 Gy. MRI/TAC were done in each implant. The following were defined: GTV, CTH-HR, CTV-IR; OAR: rectum, bladder and sigmoid. Results From 2007 to 2016: 57 patients. Patients: T1b2-T2a: 4p, T2b 41p, T3a: 2p; T3B 8p T4a: 2p; N0: 32p, N1 21p, no lymphadenectomy: 4p. Median follow up: 74.6 m (16–122 m), recurrence: 5p local, 6p node, 9p metastasis and 37p without recurrence. Local control 5 years: 90.1%; Ib2-IIB: 94.8%, III-IVa: 72.2%. (p:0.01). RDFS 5y was 92.5%; IB2-IIB: 93%, III: 85% (p:0.024); for pN0: 100%; pN+ iliac-paraaortic: 71.4% (p: 0.007). MFS 5y was 84.1%. Overall survival (OS) at 5y: 66.6% and the cancer specific survival (CEOS) was 74%. Univariate analysis survival: stage Ib2-II 83% vs. III-IVa 41% (p = 0.001); histology: squamous 78%, adenocarcinoma 59.7% (p: ns); lymph node: N0 85% vs. PA+P− 72%, and PA+P+ 35% (p = 0.010). In relation with: HR-CTV dose > 85 Gy, CEOS: 82.5% vs. 77%, and volume CTV-HR < 30 cc: 81.8% and >30 cc: 67%; p: ns. Acute grade 2–3 toxicity: rectal 15.7%, intestinal 15.7% and vesical 15.5%. Conclusion Use of interstitial HDR-BQ guided by RM increased CTV-HR dose and local control, like EMBRACE results. Nodal boost improves RDFS and perhaps OS.

Signature: Rep Pract Oncol Radiother, 2018; 23(6) : 510-516


« back

 
INDEXED IN:

Indexed in: EMBASE®, the Excerpta Medica database, the Elsevier BIOBASE (Current Awareness in Biological Sciences) and in the Index Copernicus.

http://www.sciencedirect.com/science/journal/15071367/19/2