MRI Assessment Of Tumour Spread And Response For Image Guided Cervical Cancer Brachytherapy

Main Category: Radiology / Nuclear Medicine
Also Included In: Cervical Cancer / HPV Vaccine;  Cancer / Oncology;  Clinical Trials / Drug Trials
Article Date: 22 Sep 2008 - 3:00 PST

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The treatment of choice for patients with locally advanced cervix cancer is a combination of external beam radiation therapy (EBRT), concomitant chemotherapy and brachytherapy (BT).

An image guided approach (IGBT) using magnetic resonance imaging (MRI) is becoming state of the art for the BT component of this treatment . It increases the probability of cure and decreases side effects, due to dose escalation and organ sparing.

Successful dose delivery needs appropriate placement of the brachytherapy applicators within the shrinking target and precise definition of the target structure. Both require the comprehensive understanding of tumour spread and pattern of tumour response using MRI during EBRT. To date, no MRI tumour classification for locally advanced cervical cancer has been developed to improve this understanding.

In this study, the MRI findings at diagnosis and at the time of brachytherapy were analyzed for 100 patients.

We defined five different subgroups for initial parametrial tumour spread (GTV Diagnosis) based on the predominant growth pattern and extent of invasion.

The analysis of the quality and extent of the corresponding remnants (GTV Brachytherapy or "grey zones") at the time of IGBT, showed that for each subgroup a typical response pattern was to be expected. Finally, listings with the respective frequencies and topographic distribution are presented.

Based on this systematic MRI evaluation it is possible to define five subgroups of initial tumour spread and to describe the extent, quality and topography of remnants. Now it is practical to accurately define the target within the frame of adaptive radiotherapy and in particular IGBT. Using this adaptive target approach these findings are also valuable for the development of novel combined intracavitary and interstitial BT applicators and BT application techniques.

Dimopoulos Johannes et al. Medical University of Vienna, Vienna, Austria

About ESTRO 27

ESTRO 27 (September 14th to 18th, 2008) offered an outstanding scientific programme combining lectures from eminent invited speakers, proffered papers and poster discussions, teaching lectures on a wide range of topics including clinical issues, brachytherapy, radiobiology, physics and technology as well as debates on controversial topics and clinical case discussions, a special poster reception, poster discussion sessions and electronic poster viewing.

ESTRO 27 hosted the largest European exhibition in Radiotherapy with participation from all the leading manufacturers.

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