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Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences

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Abstract

Purpose

Image-guided adaptive brachytherapy (IGABT) is currently state of the art in the comprehensive treatment of patients with cervical cancer. Here, we report mature clinical data regarding IGABT of cervical cancer in a large patient sample, examining clinical outcomes, manifestations of late toxicities, and dosimetric findings.

Methods

Between May 2012 and October 2020, we performed a total of 544 uterovaginal IGABT applications in 131 consecutive patients with biopsy-proven cervical carcinoma not suitable for surgery. The median duration of follow-up was 43 months.

Results

The estimated 3‑, 4‑, and 5‑year LC rates were 88.3% (95% confidence interval [CI] 81.1–95.5), 86.9% (95% CI 78.5–95.3), and 85.5% (95% CI 76–95%), respectively. The 3‑, 4‑, and 5‑year OS estimates were 72.66% (95% CI 63.64–81.69%), 68.9% (95% CI 59.15–78.66%), and 63.96% (95% CI 52.94–74.97%), respectively. Patients who received ≥ 5 cycles of chemotherapy had statistically significantly better 3‑year recurrence-free survival (RFS) compared to patients who completed <5 cycles (79.07% [95% CI 60.81–97.34] vs. 58.10% [95% CI 47.22–68.98]; p = 0.0185). We recorded manifestations of genitourinary and gastrointestinal toxicity grade ≥3 in 6.9% and 5.3%, respectively.

Conclusion

Our mature long-term data on the treatment patients with locally advanced cervical cancer show that excellent treatment outcomes can be achieved with MRI-based IGABT, as well as acceptable late morbidity.

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Funding

This study was supported by UNCE/MED/006 Charles University—Center of Clinical and Experimental Liver Surgery.

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Authors and Affiliations

  1. Department of Oncology and Radiotherapy, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic

    Radovan Vojtíšek MD, PhD, Emília Sukovská MD, Petra Kovářová MD &  Jindřich Fínek MD, PhD, MHA

  2. Biomedical Center, Charles University in Prague, Faculty of Medicine in Pilsen, alej Svobody 76, 323 00, Pilsen, Czech Republic

    Petr Hošek MSc., PhD

  3. Department of Imaging Methods, Charles University in Prague, Faculty of Medicine and University Hospital in Pilsen, alej Svobody 80, 304 60, Pilsen, Czech Republic

    Jan Baxa MD, PhD &  Jiří Ferda MD, PhD

Authors
  1. Radovan Vojtíšek MD, PhD
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  2. Petr Hošek MSc., PhD
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  3. Emília Sukovská MD
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  4. Petra Kovářová MD
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  5. Jan Baxa MD, PhD
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  6. Jiří Ferda MD, PhD
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  7. Jindřich Fínek MD, PhD, MHA
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Corresponding author

Correspondence to Radovan Vojtíšek MD, PhD.

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Conflict of interest

R. Vojtíšek, P. Hošek, E. Sukovská, P. Kovářová, J. Baxa, J. Ferda, and J. Fínek declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. This is an observational study. The local Ethics Committee has confirmed that no ethical approval is required. Informed consent was obtained from all individual participants included in the study.

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Vojtíšek, R., Hošek, P., Sukovská, E. et al. Treatment outcomes of MRI-guided adaptive brachytherapy in patients with locally advanced cervical cancer: institutional experiences. Strahlenther Onkol 198, 783–791 (2022). https://doi.org/10.1007/s00066-021-01887-x

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  • DOI: https://doi.org/10.1007/s00066-021-01887-x

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