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High-frequency Ultrasound Imaging of Mouse Cervical Lymph Nodes
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Image-guided Adaptive Radiotherapy in Cervical Cancer
Li Tee Tan Mbbs Mrcp Frcr Md1, Kari Tanderup PhD2, Christian Kirisits PhD3
1Department of Oncology, Cambridge University Hospitals NHS Trust, United Kingdom.
Seminars in Radiation Oncology
|April 28, 2019
Summary
Adaptive strategies for cervical cancer treatment improve outcomes by adjusting radiation doses and target volumes based on tumor response. These innovations, validated in large trials, personalize therapy for better results.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Physics
Background:
- Cervical cancer treatment traditionally uses fixed target volumes and doses.
- Tumor response varies significantly during chemoradiation, necessitating adaptive strategies.
- Image-guided brachytherapy offers opportunities for precise dose delivery.
Purpose of the Study:
- To review innovations in adaptive target volume selection for cervical cancer.
- To discuss risk-adapted dose prescription strategies.
- To present clinical outcomes and future research directions.
Main Methods:
- Review of conceptual, methodological, and technical innovations.
- Analysis of prospective and retrospective multi-center trials (EMBRACE, retroEMBRACE).
- Exploration of multi-parametric dose prescription protocols (EMBRACE-II).
Main Results:
- Adaptive target volume concept developed, reflecting tumor shrinkage.
- Image-guided brachytherapy boost delivered based on adaptive volumes.
- Risk-adapted dose prescription and technique adaptation demonstrated.
Conclusions:
- Adaptive strategies and risk-adapted dosing show potential clinical benefit in cervical cancer.
- Implementation of complex adaptive techniques presents challenges.
- Further research and dissemination are crucial for widespread adoption.
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