Stereotactic body radiotherapy boost as an alternative to brachytherapy for cervical cancer: A scoping review

IF 5.5 2区医学 Q1 HEMATOLOGY

Critical reviews in oncology/hematology Pub Date : 2024-09-18 DOI:10.1016/j.critrevonc.2024.104517

Ana Verena Silvany Sampaio de Miranda , Jessé Lopes da Silva , Diocésio Alves Pinto de Andrade , Larissa Müller Gomes , Marcela Bonalumi dos Santos , Gustavo Viani Arruda , Andreia Cristina de Melo

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引用次数: 0

Abstract

Purpose

This scoping review aims to evaluate the evidence for stereotactic body radiotherapy (SBRT) boost as a potential alternative for brachytherapy (BCT) in treating cervical cancer.

Material and methods

A comprehensive literature search was conducted across multiple databases. Studies investigating SBRT boost in cervical cancer patients who were either contraindicated for or refused BCT were included. The review examined SBRT efficacy and safety.

Results

Sixteen studies were included, encompassing prospective (n = 4) and retrospective cohort studies (n = 8), as well as phase I and II trials (n = 4). The most common SBRT boost dose was 25 Gray(Gy)/5 fractions (ranging from 18 to 40 Gy/3–5 fractions). Local control rates at 1-year, 3-year, and 5-year ranged from 86 % to 100 %, 78–92 %, and 81–92 %, respectively. Overall survival (OS) rates at 1-year, 3-year, and 5-year rates ranged from 49 % to 95 %, 50–77 %, and 50–69 %, respectively. Two studies reported a pathological complete response rate of 93 % and 94 % three months after the SBRT boost. Most studies reported low rates of late grade 3 or higher genitourinary (0–14 %) and gastrointestinal (0–26 %) toxicities. The overall incidence of rectovaginal fistulas ranged from 0 % to 13 %.

Conclusion

This scoping review suggests SBRT boost as a promising alternative to selected cervical cancer patients who cannot receive BCT. The results indicate a high local control with acceptable toxicity profiles. However, further research is needed to define optimal SBRT boost parameters, identify patient selection criteria, and address knowledge gaps regarding long-term outcomes and cost-effectiveness.

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立体定向体放射治疗作为近距离放射治疗宫颈癌的替代疗法：范围界定综述。

目的：本综述旨在评估立体定向体放射治疗（SBRT）作为近距离放射治疗（BCT）的潜在替代方法治疗宫颈癌的证据：在多个数据库中进行了全面的文献检索。材料：在多个数据库中进行了全面的文献检索，纳入了对有BCT禁忌症或拒绝BCT的宫颈癌患者进行SBRT增强治疗的研究。综述考察了SBRT的有效性和安全性：结果：共纳入16项研究，包括前瞻性（4项）和回顾性队列研究（8项），以及I期和II期试验（4项）。最常见的SBRT增强剂量为25 Gray(Gy)/5次（18 - 40Gy/3至5次不等）。1年、3年和5年的局部控制率分别为86%至100%、78%至92%和81%至92%。1年、3年和5年的总生存率（OS）分别为49%至95%、50%至77%和50%至69%。两项研究报告称，SBRT 增效三个月后的病理完全反应率分别为 93% 和 94%。大多数研究报告的晚期3级或以上泌尿生殖系统（0-14%）和胃肠道（0-26%）毒性发生率较低。直肠阴道瘘的总发生率为0-13%：本次范围界定综述表明，对于无法接受 BCT 的特定宫颈癌患者而言，SBRT 增效疗法是一种很有前景的替代疗法。结果表明，SBRT 的局部控制率高，毒性也可接受。然而，还需要进一步的研究来确定最佳的SBRT增强参数，确定患者选择标准，并解决长期疗效和成本效益方面的知识差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Critical reviews in oncology/hematology 医学-血液学

CiteScore

11.00

自引率

3.20%

发文量

213

审稿时长

55 days

期刊介绍： Critical Reviews in Oncology/Hematology publishes scholarly, critical reviews in all fields of oncology and hematology written by experts from around the world. Critical Reviews in Oncology/Hematology is the Official Journal of the European School of Oncology (ESO) and the International Society of Liquid Biopsy.