Magnetresonanztomographisch gesteuerte Brachytherapie bei Gebärmutterhalskrebs : Prognostische Faktoren für das Überleben.

Kim, Yeon-Joo; Kim, Joo-Young; Kim, Youngkyong; Lim, Young; Jeong, Jonghwi; Jeong, Chiyoung; Kim, Meyoung; Lim, Myong; Seo, Sang-Soo; Park, Sang-Yoon; Lim, Young Kyung; Lim, Myong Cheol

<bold>Objective: </bold>The purpose of this work was to identify prognostic factors for survival after magnetic resonance image (MRI)-guided brachytherapy combined with external beam radiotherapy for cervical cancer.<bold>Material and Methods: </bold>External beam radiotherapy of 45-50.4 Gy was delivered by either three-dimensional conformal radiotherapy or helical tomotherapy. Patients also received high-dose-rate MRI-guided brachytherapy of 5 Gy in 6 fractions.<bold>Results: </bold>We analyzed 128 patients with International Federation of Gynecology and Obstetrics stage IB-IVB cervical cancer who underwent MRI-guided brachytherapy. Most patients (96 %) received concurrent chemotherapy. Pelvic lymph node metastases and para-aortic lymphadenopathies were found in 62 % and 14 % of patients, respectively. The median follow-up time was 44 months. Complete remission was achieved in 119 of 128 patients (93 %). The 5‑year local recurrence-free, cancer-specific, and overall survival rates were 94, 89, and 85 %, respectively. Negative pelvic lymphadenopathy, gross tumor volume (GTV) dose covering 90 % of the target (GTV D90) of >110 Gy, and treatment duration ≤56 days were associated with better overall survival in univariate analyses. Multivariable analysis showed that GTV D90 of >110 Gy and treatment duration ≤56 days were possibly associated with overall survival with near-significant P-values of 0.062 and 0.073, respectively.<bold>Conclusions: </bold>The outcome of MRI-guided brachytherapy combined with external beam radiotherapy in patients with cervical cancer was excellent. GTV D90 of >110 Gy and treatment duration ≤56 days were potentially associated with overall survival.

CLINICAL trials; COMBINED modality therapy; COMPARATIVE studies; MAGNETIC resonance imaging; RESEARCH methodology; MEDICAL cooperation; RADIATION doses; RADIATION injuries; RADIOISOTOPE brachytherapy; RADIOTHERAPY; RECTAL diseases; RESEARCH; SURVIVAL; CERVIX uteri tumors; EVALUATION research; TREATMENT effectiveness; DISEASE prevalence; PREVENTION

Strahlentherapie und Onkologie, 2016, Vol 192, Issue 12, p922

0179-7158

Academic Journal

10.1007/s00066-016-1049-x