Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2014

Open Access 01-12-2014 | Research

Dosimetric feasibility of stereotactic body radiation therapy as an alternative to brachytherapy for definitive treatment of medically inoperable early stage endometrial cancer

Authors: Ryan Jones, Quan Chen, Ryan Best, Bruce Libby, Edwin F Crandley, Timothy N Showalter

Published in: Radiation Oncology | Issue 1/2014

Login to get access

Abstract

Purpose

This study was designed to evaluate the dosimetric feasibility of definitive stereotactic body radiation therapy (SBRT) for the treatment of medically inoperable early stage endometrial cancer.

Methods

CT simulation scans from 10 medically inoperable early stage endometrial cancer patients previously treated with high dose-rate (HDR) intracavitary brachytherapy were used to generate Helical Tomotherapy (HT) plans using the IMRT mode with clinical target volumes (CTVs) that included the uterus plus cervix. A prescription dose of 34 Gy in 4 fractions was used. The SBRT dosimetry was compared to the 10 prior intracavitary brachytherapy plans normalized to a standard dose. Organs at risk (OARs) evaluated were the bladder, rectum, sigmoid, femoral heads, and other bowel, including both large and small bowel. The simulation CT and daily image guidance for 4 patients treated with this technique were evaluated to assess for interfraction variation in the uterine position and effects on dosimetry.

Results

Compared to intracavitary brachytherapy, HT SBRT produced significantly greater overall target coverage to the uterus, boost CTV, and PTV, with exception of the V150% of the uterus. HT SBRT significantly increased dose to the rectum, bowel, and femoral heads compared to intracavitary brachytherapy, though not outside of dose tolerance limits. Review of daily image guidance for patients treated with this technique demonstrated good reproducibility with a mean overlap index of 0.87 (range, 0.74 – 0.99).

Conclusions

Definitive SBRT for medically inoperable early stage endometrial cancer appears to be a feasible treatment option. Future studies are warranted to evaluate long-term clinical outcomes with this technique, compared to HDR intracavitary brachytherapy.
Appendix
Available only for authorised users
Literature
1.
American Cancer Society: Cancer Facts & Figures 2013. Atlanta: American Cancer Society; 2013.
2.
Howlader N, Noone AM, Krapcho M, Garshell J, Neyman N, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Cho H, Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (Eds): SEER Cancer Statistics Review, 1975-2010. Bethesda, MD: National Cancer Institute; , based on November 2012 SEER data submission, posted to the SEER web site, April 2013 http://​seer.​cancer.​gov/​csr/​1975_​2010/​
3.
4.
Coon D, Beriwal S, Heron DE, Kelley JL, Edwards RP, Sukumvanich P, Zorn KK, Krivak TC: High-dose-rate Rotte “Y” applicator brachytherapy for definitive treatment of medically inoperable endometrial cancer: 10-year results. Int J Radiat Oncol Biol Phys 2008,71(3):779-783.CrossRefPubMed
5.
Nag S, Erickson BA, Parikh S, Gupta N, Varia M, Glasgow G: The American brachytherapy society recommendations for high-dose-rate brachytherapy for carcinoma of the endometrium. Int J Radiat Oncol Biol Phys 2000,48(3):779-790.CrossRefPubMed
6.
Chao CK, Grigsby PW, Perez CA, Camel HM, Kao MS, Galakatos AE, Boyle WA: Brachytherapy-related complications for medically inoperable stage I endometrial carcinoma. Int J Radiat Oncol Biol Phys 1995,31(1):37-42.CrossRefPubMed
7.
Lanciano R, Corn B, Martin E, Schultheiss T, Hogan WM, Rosenblum N: Perioperative morbidity of intracavitary gynecologic brachytherapy. Int J Radiat Oncol Biol Phys 1994,29(5):969-974.CrossRefPubMed
8.
Dusenbery KE, Carson LF, Potish RA: Perioperative morbidity and mortality of gynecologic brachytherapy. Cancer 1991,67(11):2786-2790.CrossRefPubMed
9.
Niazi TM, Souhami L, Portelance L, Bahoric B, Gilbert L, Stanimir G: Long-term results of high-dose-rate brachytherapy in the primary treatment of medically inoperable stage I-II endometrial carcinoma. Int J Radiat Oncol Biol Phys 2005,63(4):1108-1113.CrossRefPubMed
10.
Nguyen T-V, Petereit DG: High-dose-rate brachytherapy for medically inoperable stage I endometrial cancer. Gynecol Oncol 1998, 71: 196-203.CrossRefPubMed
11.
Taylor A, Powell ME: An assessment of interfractional uterine and cervical motion: implications for radiotherapy target volume definition in gynaecological cancer. Radiother Oncol 2008,88(2):250-257.CrossRefPubMed
12.
van de Bunt L, Jurgenliemk-Schulz IM, de Kort GA, Roesink JM, Tersteeg RJ, van der Heide UA: Motion and deformation of the target volumes during IMRT for cervical cancer: what margins do we need? Radiother Oncol 2008,88(2):233-240.CrossRefPubMed
13.
Kemmerer E, Hernandez E, Ferriss JS, Valakh V, Miyamoto C, Li S, Micaily B: Use of image-guided stereotactic body radiation therapy in lieu of intracavitary brachytherapy for the treatment of inoperable endometrial neoplasia. Int J Radiat Oncol Biol Phys 2013,85(1):129-135.CrossRefPubMed
14.
Beriwal S, Kim H, Heron DE, Selvaraj R: Comparison of 2D vs. 3D dosimetry for Rotte ‘Y’ applicator high dose rate brachytherapy for medically inoperable endometrial cancer. Technol Cancer Res Treat 2006,5(5):521-527.CrossRefPubMed
15.
Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B, Keall P, Lovelock M, Meeks S, Papiez L, Purdie T, Sadagopan R, Schell MC, Salter B, Schlesinger DJ, Shiu AS, Solberg T, Song DY, Stieber V, Timmerman R, Tomé WA, Verellen D, Wang L, Yin FF: Stereotactic body radiation therapy: the report of AAPM task group 101. Med Phys 2010,37(8):4078-4101.CrossRefPubMed
16.
17.
Viswanathan AN, Beriwal S, De Los Santos JF, Demanes DJ, Gaffney D, Hansen J, Jones E, Kirisits C, Thomadsen B, Erickson B, American Brachytherapy Society: American brachytherapy society consensus guidelines for locally advanced carcinoma of the cervix: part II: high-dose rate brachytherapy. Brachytherapy 2012,11(1):47-52.PubMedCentralCrossRefPubMed
18.
Pötter R, Haie-Meder C, Van Limbergen E, Barillot I, De Brabandere M, Dimopoulos J, Dumas I, Erickson B, Lang S, Nulens A, Petrow P, Rownd J, Kirisits C, GEC ESTRO Working Group: Recommendations from gynaecological(GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy–3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiother Oncol 2006, 78: 67-77.CrossRefPubMed
19.
Thompson SR, Delaney GP, Gabriel GS, Jacob S, Das P, Barton MB: Estimation of the optimal brachytherapy utilization rate in the treatment of gynecological cancers and comparison with patterns of care. Int J Radiat Oncol Biol Phys 2013,85(2):400-405.CrossRefPubMed
20.
Sharma C, Deutsch I, Horowitz DP, Hershman DL, Lewin SN, Lu YS, Neugut AI, Herzog TJ, Chao CK, Wright JD: Patterns of care and treatment outcomes for elderly women with cervical cancer. Cancer 2012,118(14):3618-3626.CrossRefPubMed
21.
Han K, Milosevic M, Fyles A, Pintilie M, Viswanathan AN: Trends in the utilization of brachytherapy in cervical cancer in the United States. Int J Radiat Oncol Biol Phys 2013,87(1):111-119.CrossRefPubMed
Metadata
Title
Dosimetric feasibility of stereotactic body radiation therapy as an alternative to brachytherapy for definitive treatment of medically inoperable early stage endometrial cancer
Authors
Ryan Jones
Quan Chen
Ryan Best
Bruce Libby
Edwin F Crandley
Timothy N Showalter
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2014
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-9-164

Other articles of this Issue 1/2014

Radiation Oncology 1/2014 Go to the issue

Research

The role of whole brain radiation therapy in the management of melanoma brain metastases

Research

Assessment of the risk factors for impending fractures following radiotherapy for long bone metastases using CT scan-based virtual simulation: a retrospective study

Research

Independent absorbed-dose calculation using the Monte Carlo algorithm in volumetric modulated arc therapy

Research

Target volume delineation in breast conserving radiotherapy: are co-registered CT and MR images of added value?

Research

Deformable versus rigid registration of PET/CT images for radiation treatment planning of head and neck and lung cancer patients: a retrospective dosimetric comparison

Research

PTV margin definition in hypofractionated IGRT of localized prostate cancer using cone beam CT and orthogonal image pairs with fiducial markers