3D MRI-based brachytherapy in patients with locally advanced cervical carcinoma – early clinical results

Czech version

Authors: M. Doležel ^1,2,5; J. Vaňásek ¹; K. Odrážka ^1,2; T. Kroulík ¹; K. Kudelka ¹; M. Tichý ³; M. Košťál ³; Z. Vocásek ⁴
Authors‘ workplace: KOC, Pardubická krajská nemocnice, a. s., a Multiscan, s. r. o., Pardubice, primář doc. MUDr. J. Vaňásek, CSc. ¹; 1. lékařská fakulta, Univerzita Karlova, Praha ²; Porodnicko-gynekologické oddělení, Pardubická krajská nemocnice, a. s., Pardubice ³; Porodnicko-gynekologické oddělení, Masarykova městská nemocnice v Jilemnici, Jilemnice ⁴; Onkologická klinika, FN, Olomouc ⁵
Published in: Ceska Gynekol 2012; 77(6): 507-513

Overview

Objective:
To demonstrate the clinical benefit of MRI-based brachytherapy using CT and MRI data fusion.

Design:
Clinical trial.

Setting:
Oncology Centre, Multiscan and Pardubice Regional Hospital, Pardubice.

Methods:
Thirty six patients with locally advanced cervical cancer were treated with MRI-based brachytherapy (MRI-based preplanning 15 patients, MRI approximation 21 patients). All patients were continuously followed during and after treatment. Tumor control and toxicity were evaluated at each visit. Late gastrointestinal and genitourinary symptoms were recorded, using Fox Chase (FC) modification of the Radiation Therapy Oncology Group (RTOG) and Late Effects Normal Tissue Task Force (LENT) toxicity criteria.

Results:
We observed no complications during the entire MRI procedure at the radiology department. The cumulative incidence of grade ≥ 2 late genitourinary and gastrointestinal toxicity at median follow up of 30.3 months was 4.8% and 9.5% for MRI approximation, respectively 0% and 13.3% for MRI-based preplanning. Local control was 86.7% for MRI-based preplanning and 76.2% for MRI approximation.

Conclusion:
3D MRI-based brachytherapy with consecutive CT/MRI data fusion yields excellent local control with minor toxicity.

Key words:
MRI-based brachytherapy, cervical cancer, clinical results.

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