CT Imaging with Radiation Therapy Found Efficient in Controlling Stage 1-2 Cervical Cancer

CT Imaging with Radiation Therapy Found Efficient in Controlling Stage 1-2 Cervical Cancer

A 10-year evaluation study investigating the clinical outcomes of patients with stage 1-2 cervical cancer treated with imaging combined with radiation therapy found the method efficient in controlling tumors and resulted in increased survival of patients.

The study, “Outcomes with volume-based dose specification in CT-planned high-dose-rate brachytherapy for stage I-II cervical carcinoma: A 10-year institutional experience,” was published in Gynecologic Oncology.

Cervical cancer is treated using various advanced technologies, including imaging combined with radiation therapy — called computed tomography (CT)-planned high-dose-rate (HDR) intracavitary brachytherapy (BT). However, despite the increasing use of this procedure, the clinical outcomes and prognostic factors were still not fully known.

In this study, the researchers aimed to clarify these factors by estimating the progression-free survival (PFS) and overall survival (OS) of patients with stage 1-2 cervical-cancer treated by CT planned HDR image-based BT.

Among 150 patients with stage 1-2 cervical cancer treated with CT-planned BT between April 2004 and October 2014, a total of 128 met the criteria for the study. The local control of the tumors was estimated using parameters like Kaplan-Meier local control (LC) and pelvic control (PC), and the OS and PFS of the patients were then determined.

After a follow-up of 30 months, the participants showed a two-year LC rate of 96%, a PFS of 88%, and an OS of 88%. Eighteen patients experienced any recurrence of cancer, eight of them showed distant recurrence, and 10 patients had recurrences of the tumors as local, pelvic, regional or distant recurrence forms.

The data also illustrated that tumor size played an important role in recurrence after the treatment. Patients with larger tumors were 3.3 times at higher risk of experiencing any recurrence compared to those with smaller tumors found to shrink more easily.

In terms of side effects, grade 2 late toxicity was experienced by two patients and acute or late grade 3 toxicities were absent.

“CT-planned BT resulted in excellent local control and survival,” the authors wrote. “Large tumor size was associated with an increased risk of recurrence outside the radiation field and worse PFS and OS. A volume-optimized plan treated a smaller area than a point A standard plan for patients with Stage I-II cervical cancer that have received chemoradiation.”

“Given the outstanding LC achieved with modern therapy including chemoradiation, HDR, and image-based BT, further efforts to combat spread outside the radiation field with novel therapies is warranted,” they added.

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Malika Ammam received her MS degree from the University of Pierre et Marie CURIE in July 2002 and her PhD from the University of Paris Sud XI, France in September 2005. From 2006 to 2007, she worked as a research fellow at the University of Kansas in collaboration with Pinnacle Technology Inc. (USA). From 2007 to 2010, she was a research associate at KU Leuven, Belgium. From 2010 to 2012, she worked at the University of Ontario Institute of Technology in collaboration with Alcohol Countermeasure Systems Corporation, Canada. She has also held the prestigious Rosalind Franklin fellowship.

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