MRI-based image-guided adaptive brachytherapy for locally advanced cervical cancer in clinical routine: a single-institution experience.

IF 2.3 4区医学 Q3 ONCOLOGY

Pathology & Oncology Research Pub Date : 2025-05-01 eCollection Date: 2025-01-01 DOI:10.3389/pore.2025.1612077

Zoltán Végváry, Renáta Kószó, Zsófia Együd, Linda Varga, Viktor Róbert Paczona, Adrienn Cserháti, Viorica Gal, Zoltán Varga, Zoltán Nagy, Bence Deák, Ferenc Borzák, Julianna Bontovics, Emese Fodor, Judit Oláh, Zsuzsanna Kahán

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引用次数: 0

Abstract

Background: MRI-based image-guided adaptive brachytherapy (IGABT) is a new approach for individual dose escalation and control of organ at risk (OAR) doses and toxicities in the treatment of locally advanced cervical cancer.

Methods: Various radiotherapy-related parameters and the feasibility of the treatment based on acute toxicity were analyzed in a total of 50 cases in two cohorts who received a brachytherapy (BT) boost after definitive chemoradiotherapy with either an MRI-based IGABT technique (24 patients) or CT-only image guidance (26 patients). For target volume, OAR delineation, and dose prescription, the EMBRACE II protocol was followed.

Results: The features of the target volumes and dose coverage did not differ between the two groups regarding teletherapy. At BT, however, while the High-Risk Clinical Target Volumes (CTVHR) did not differ the D90 dose coverage was significantly higher in the MRI-based IGABT group than in the non-MRI-based group (7.37 ± 0.55 Gy vs. 6.87 ± 0.84 Gy, p = 0.015). The CTVHR D98 doses showed a strong trend in favor of the MRI-based technique (6.16 ± 0.59 Gy, vs. 5.72 ± 0.95 Gy, p = 0.051). Cumulative doses to the CTVHR by means of both D90 and D98 were significantly higher in the MRI-based treatment group than the other group (86.64 ± 4.76 Gy vs. 81.56 ± 8.29 Gy, p = 0.011 and 77.23 ± 4.39 Gy vs. 73.40 ± 7.80 Gy, p = 0.037, respectively). Regarding OAR exposure, doses to the bladder, rectum, and sigmoid did not differ between the two cohorts.

Conclusion: Our first clinical results support the implementation of IGABT as a key component of image-guided adaptive radiotherapy (IGART) aiming at tumor dose-escalation and OAR protection.

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基于mri的图像引导适应性近距离治疗局部晚期宫颈癌的临床常规：单一机构的经验。

背景：基于mri的图像引导适应性近距离放射治疗（IGABT）是局部晚期宫颈癌治疗中个体剂量递增和危险器官（OAR）剂量和毒性控制的新方法。方法：分析两组共50例患者的各种放疗相关参数和基于急性毒性的治疗可行性，这些患者在接受基于mri的IGABT技术（24例）或仅ct图像指导（26例）的明确放化疗后接受近距离放疗（BT）增强。靶体积、OAR划定和剂量处方均采用EMBRACE II方案。结果：两组远程治疗靶体积和剂量覆盖特征无明显差异。然而，在BT，尽管高危临床靶体积（CTVHR）没有差异，但基于mri的IGABT组的D90剂量覆盖率显著高于非mri组（7.37±0.55 Gy vs. 6.87±0.84 Gy, p = 0.015）。CTVHR D98剂量显示强烈倾向于基于mri的技术（6.16±0.59 Gy, vs. 5.72±0.95 Gy, p = 0.051）。mri治疗组D90和D98对CTVHR的累积剂量均显著高于另一组（86.64±4.76 Gy vs. 81.56±8.29 Gy, p = 0.011; 77.23±4.39 Gy vs. 73.40±7.80 Gy, p = 0.037）。关于OAR暴露，膀胱、直肠和乙状结肠的剂量在两个队列中没有差异。结论：我们的第一个临床结果支持IGABT作为图像引导适应性放疗（IGART）的关键组成部分，旨在肿瘤剂量递增和OAR保护。

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

Pathology & Oncology Research 医学-病理学

CiteScore

6.30

自引率

0.00%

发文量

134

审稿时长

4-8 weeks

期刊介绍： Pathology & Oncology Research (POR) is an interdisciplinary Journal at the interface of pathology and oncology including the preclinical and translational research, diagnostics and therapy. Furthermore, POR is an international forum for the rapid communication of reviews, original research, critical and topical reports with excellence and novelty. Published quarterly, POR is dedicated to keeping scientists informed of developments on the selected biomedical fields bridging the gap between basic research and clinical medicine. It is a special aim for POR to promote pathological and oncological publishing activity of colleagues in the Central and East European region. The journal will be of interest to pathologists, and a broad range of experimental and clinical oncologists, and related experts. POR is supported by an acknowledged international advisory board and the Arányi Fundation for modern pathology.