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Stereotactic body radiation therapy via helical tomotherapy to replace brachytherapy for brachytherapy-unsuitable cervical cancer patients - a preliminary result.

Hsieh CH, Tien HJ, Hsiao SM, Wei MC, Wu WY, Sun HD, Wang LY, Hsieh YP, Chen YJ, Shueng PW - Onco Targets Ther (2013)

Bottom Line: There were no grade 3 or 4 subacute toxicities.Three patients suffered from manageable rectal bleeding in months 11, 14, and 25, respectively.One stage I VA patient experienced fistula formation in month 3.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan; ; Department of Medicine ; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan;

ABSTRACT

Aim: To review the experience and to evaluate the results of stereotactic body radiation therapy (SBRT) via helical tomotherapy (HT), for the treatment of brachytherapy-unsuitable cervical cancer.

Methods: Between September 1, 2008 to January 31, 2012, nine cervical cancer patients unsuitable for brachytherapy were enrolled. All of the patients received definitive whole pelvic radiotherapy with or without chemotherapy, followed by SBRT via HT.

Results: The actuarial locoregional control rate at 3 years was 78%. The mean biological equivalent dose in 2-Gy fractions of the tumor, rectum, bladder, and intestines was 76.0 ± 7.3, 73.8 ± 13.2, 70.5 ± 10.0, and 43.1 ± 7.1, respectively. Only two had residual tumors after treatment, and the others were tumor-free. Two patients experienced grade 3 acute toxicity: one had diarrhea; and another experienced thrombocytopenia. There were no grade 3 or 4 subacute toxicities. Three patients suffered from manageable rectal bleeding in months 11, 14, and 25, respectively. One stage I VA patient experienced fistula formation in month 3.

Conclusion: SBRT via HT provides the possibility for treatment of locally advanced cervical cancer in patients who are unsuitable for brachytherapy. Long-term follow up and enrollment of more such patients to receive SBRT via the HT technique are warranted.

No MeSH data available.


Related in: MedlinePlus

Locally advanced cervical cancer patients received whole pelvic radiotherapy concurrent with or without chemotherapy, followed by stereotactic body radiation therapy via helical tomotherapy. (A) Overall survival curve; (B) disease-free survival curve; (C) locoregional control curve; and (D) metastases-free survival curve.
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f1-ott-6-059: Locally advanced cervical cancer patients received whole pelvic radiotherapy concurrent with or without chemotherapy, followed by stereotactic body radiation therapy via helical tomotherapy. (A) Overall survival curve; (B) disease-free survival curve; (C) locoregional control curve; and (D) metastases-free survival curve.

Mentions: The median survival was 13 months (range, 4–40 months). The actuarial 3-year OS, disease-free survival, locoregional control, and metastases-free survival rates were 46.9%, 25.9%, 77.8%, and 28.6%, respectively (Figure 1). Two stage IVA patients without concurrent chemotherapy had residual tumors after radiotherapy was completed. The others (7/9) had no locoregional recurrence upon confirmation of follow-up images and PAP. Four of nine (44%) patients experienced distant metastasis: Patient 1 had bone metastasis; Patient 5 had lung metastasis; Patient 7 had bone and lung metastasis; and Patient 9 experienced liver metastasis. Fifty-six percent of patients (5/9) were surviving at the time of this report.


Stereotactic body radiation therapy via helical tomotherapy to replace brachytherapy for brachytherapy-unsuitable cervical cancer patients - a preliminary result.

Hsieh CH, Tien HJ, Hsiao SM, Wei MC, Wu WY, Sun HD, Wang LY, Hsieh YP, Chen YJ, Shueng PW - Onco Targets Ther (2013)

Locally advanced cervical cancer patients received whole pelvic radiotherapy concurrent with or without chemotherapy, followed by stereotactic body radiation therapy via helical tomotherapy. (A) Overall survival curve; (B) disease-free survival curve; (C) locoregional control curve; and (D) metastases-free survival curve.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569375&req=5

f1-ott-6-059: Locally advanced cervical cancer patients received whole pelvic radiotherapy concurrent with or without chemotherapy, followed by stereotactic body radiation therapy via helical tomotherapy. (A) Overall survival curve; (B) disease-free survival curve; (C) locoregional control curve; and (D) metastases-free survival curve.
Mentions: The median survival was 13 months (range, 4–40 months). The actuarial 3-year OS, disease-free survival, locoregional control, and metastases-free survival rates were 46.9%, 25.9%, 77.8%, and 28.6%, respectively (Figure 1). Two stage IVA patients without concurrent chemotherapy had residual tumors after radiotherapy was completed. The others (7/9) had no locoregional recurrence upon confirmation of follow-up images and PAP. Four of nine (44%) patients experienced distant metastasis: Patient 1 had bone metastasis; Patient 5 had lung metastasis; Patient 7 had bone and lung metastasis; and Patient 9 experienced liver metastasis. Fifty-six percent of patients (5/9) were surviving at the time of this report.

Bottom Line: There were no grade 3 or 4 subacute toxicities.Three patients suffered from manageable rectal bleeding in months 11, 14, and 25, respectively.One stage I VA patient experienced fistula formation in month 3.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan; ; Department of Medicine ; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan;

ABSTRACT

Aim: To review the experience and to evaluate the results of stereotactic body radiation therapy (SBRT) via helical tomotherapy (HT), for the treatment of brachytherapy-unsuitable cervical cancer.

Methods: Between September 1, 2008 to January 31, 2012, nine cervical cancer patients unsuitable for brachytherapy were enrolled. All of the patients received definitive whole pelvic radiotherapy with or without chemotherapy, followed by SBRT via HT.

Results: The actuarial locoregional control rate at 3 years was 78%. The mean biological equivalent dose in 2-Gy fractions of the tumor, rectum, bladder, and intestines was 76.0 ± 7.3, 73.8 ± 13.2, 70.5 ± 10.0, and 43.1 ± 7.1, respectively. Only two had residual tumors after treatment, and the others were tumor-free. Two patients experienced grade 3 acute toxicity: one had diarrhea; and another experienced thrombocytopenia. There were no grade 3 or 4 subacute toxicities. Three patients suffered from manageable rectal bleeding in months 11, 14, and 25, respectively. One stage I VA patient experienced fistula formation in month 3.

Conclusion: SBRT via HT provides the possibility for treatment of locally advanced cervical cancer in patients who are unsuitable for brachytherapy. Long-term follow up and enrollment of more such patients to receive SBRT via the HT technique are warranted.

No MeSH data available.


Related in: MedlinePlus