MRI-Guided Adaptive Brachytherapy Beneficial in Cervical Cancer

THURSDAY, Jan. 12, 2023 (HealthDay News) — A magnetic resonance imaging-based image-guided adaptive brachytherapy (MR-IGABT) approach is beneficial for locally advanced cervical cancer, according to a study published online Jan. 4 in the Journal of Clinical Oncology.

Maximilian P. Schmid, M.D., from the Medical University of Vienna, and colleagues reported patterns of remission and failure and risk factors for local failure (LF) from the EMBRACE-I study, which involved treatment with external beam radiotherapy, concurrent chemotherapy, and MR-IGABT for locally advanced cervical cancer. Data were included for 1,318 patients with a median follow-up of 52 months.

The researchers found that at three months after the end of treatment, 81 patients had persistent disease; of these patients, 60 achieved local tumor control at six to nine months without further treatment and 21 had progressive disease. In addition, a local recurrence developed after complete remission in 77 patients, comprising a total of 98 LFs. In 90 percent of patients with LF, LFs were located inside the MR-IGABT target volumes. A significant impact on LF was seen in a multivariable analysis for factors such as histology, minimal dose to 90 percent of high-risk clinical target volume (CTV_HR), maximum tumor dimension, and CTV_HR >45 cm³. A minimal dose to 90 percent of 85 Gy to the CTV_HR led to local tumor control of 95 percent at three years postintervention for squamous cell versus 86 percent for adeno/adenosquamous carcinoma histology.

“This is the first time we have seen that different brachytherapy doses are required for individual parameters such as different histologies or different tumor sizes,” Schmid said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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