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European Journal of Gynaecological Oncology  2021, Vol. 42 Issue (1): 73-80    DOI: 10.31083/j.ejgo.2021.01.2189
Original Research Previous articles | Next articles
3D image guided adaptive brachytherapy in patients with locally advanced cervical cancer: experience and clinical results from a minimum of six years of follow-up
Marit Sundset1, *(), Anne Dybdahl Wanderås2, Signe Danielsen2, 3, Mirjam Delange Alsaker2, Bjørn Hagen1, Anne Beate Langeland Marthinsen2, 3
1Department of Obstetrics and Gynecology, Section of Gynecological Oncology, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
2Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
3Department of Physics, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
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Abstract  
In 2005, individualized 3D image guided brachytherapy was implemented for cervical cancer patients, in accordance with the (GYN) GEC ESTRO recommendation, at St. Olav's Hospital, Trondheim, Norway. This study reports the clinical results of sixty-five consecutive patients treated from 2005 to 2010. The patients were treated with curative intent using external beam radiotherapy, brachytherapy and cisplatin. Results of this treatment are presented, including Kaplan-Meier estimates for overall survival (OS) and cancer specific survival (CSS), as well as biological effective dose normalized to equivalent 2 Gy fractions to tumor, defined as high-risk clinical target volume (CTVHR ), and to organs at risk (OARs, here bladder and rectum). Morbidity was prospectively assessed and scored in accordance with the CTCAE 3.0. 92% of the patients achieved treatment response. Local control (LC) remained in all but one patient during follow-up. Five-year OS and CSS were 71% and 80%, respectively. The mean minimum dose to CTVHR for all patients was 80.2 ± 7.3 Gy; 16% and 23% of the patients developed bladder and GI symptoms respectively, 14% of all symptoms were categorized as serious (CTCAE score ≥ 3). A dose-effect relationship was observed for adverse effects of the bladder, and the findings support the more recently recommended lower total dose limit for this OAR.
Key words:  Cervical cancer      Radiotherapy      Brachytherapy      Follow-up     
Submitted:  07 July 2020      Revised:  08 August 2020      Accepted:  31 August 2020      Published:  15 February 2021     
*Corresponding Author(s):  Marit Sundset     E-mail:  Marit.Sundset@stolav.no

Cite this article: 

Marit Sundset, Anne Dybdahl Wanderås, Signe Danielsen, Mirjam Delange Alsaker, Bjørn Hagen, Anne Beate Langeland Marthinsen. 3D image guided adaptive brachytherapy in patients with locally advanced cervical cancer: experience and clinical results from a minimum of six years of follow-up. European Journal of Gynaecological Oncology, 2021, 42(1): 73-80.

URL: 

https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2021.01.2189     OR     https://ejgo.imrpress.com/EN/Y2021/V42/I1/73

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