(Press-News.org) Barcelona, Spain: The first large international study to investigate the late side-effects of a combination of two forms of brachytherapy to treat cervical cancer has shown that the technique successfully delivers higher radiation doses to the tumour without an increase in treatment-related problems afterwards.
Brachytherapy is a type of internal radiotherapy that involves putting a radioactive source close to, or in the tumour. It is often performed after a CT or MRI scan has pinpointed the exact position of the cancer, so that the radiation treatment can be targeted precisely; this is called image-guided brachytherapy (IGBT). During intracavitary (IC) brachytherapy, the radioactive applicator is placed in the uterus and the vagina, while interstitial (IS) brachytherapy involves inserting needles directly into the tumour to deliver the radiation.
In a presentation to the 3rd ESTRO Forum in Barcelona, Spain, on Saturday, Dr Lars Fokdal (MD, PhD), a consultant at the Aarhus University Hospital, Denmark, will say: "Image-guided brachytherapy has transformed treatment for cervical cancer considerably, and dose adaptation and a combination of intracavitary and interstitial brachytherapy enable us to deliver radiation that is targeted at the tumour while avoiding other organs. However, although some centres are using IC/IS brachytherapy, there are concerns that the technique might increase the likelihood of adverse side-effects occurring three months or more after the end of radiation treatment."
Dr Fokdal and colleagues in Austria, France, UK, Slovenia, The Netherlands and Ireland, enrolled 731 women with cervical cancer that had started to spread into nearby tissues (locally advanced) into the "retroEMBRACE" study - a study that collected retrospective data on the use of IGBT to treat cervical cancer in nearly 800 women in 12 different countries. The researchers analysed data from a group of 300 patients from institutions that systematically used combined IC and IS brachytherapy on more than 20% of women, and a group of 310 patients from institutions where the most common treatment used was IC brachytherapy alone.
"We found that combined IC/IS brachytherapy enabled us to deliver higher doses to the tumour without delivering more radiation to the bladder and the bowel. This meant that there was no increased risk in severe adverse side-effects three or more months later, but there is a better chance of a cure," he will tell the conference.
"These results show that combined IC/IS brachytherapy is a good treatment and should serve as a benchmark for future brachytherapy in cervical cancer."
Problems (morbidity) caused by radiotherapy for cervical cancer can include bladder and bowel dysfunction; in rare cases they can include the narrowing, loss of flexibility or drying of the vagina or bowel (known as stenosis) or holes forming in the wall of the vagina, bowel or bladder (fistulas). These are graded from 0 for no problems to 5 for death related to radiation treatment.
After a median follow-up of 40 months, ranging from three to 163 months, the researchers found there was no significant difference in late bladder, gastro-intestinal or vaginal grade 2-5 morbidities between the two groups of patients.
Among the patients in the group more likely to receive IC/IS brachytherapy, 66% (versus 52% in the other group) received high-dose rate brachytherapy, and 47% versus 4% received the combined IC/IS treatment. In addition, 97% (versus 66%) of patients in the IC/IS group benefited from their radiation doses being planned with the aid of MRI scans. Compared to the group least likely to receive IC/IS brachytherapy, the radiation dose in the IC/IS group of patients reached more of the targeted tumour area, with at least 90% of the tumours receiving a dose that was 9Gy higher than in the non-IC-IS patients. However, these higher, targeted doses in the IC/IS group of patients did not result in higher doses of radiation to the bowel, and radiation doses to the bladder was an average of 4Gy lower.
Professor Philip Poortmans, President of ESTRO, commented: "Dr Fokdal and colleagues show again that intensive close collaboration between high-level departments from several countries can help to extend our knowledge of how to further improve the outcome of our patients. This specific study of the EMBRACE network shows how the best results may be obtained by properly using the newest technical developments in the field of brachytherapy. Now, the next step is to teach these optimised techniques to all our other colleagues who treat locally advanced cervical cancer but do not yet use interstitial techniques as an addition to intracavitary ones."
INFORMATION:
Depression is not linked to violence among males
Some delinquent youth with current psychiatric illness may be violent
Providing treatment could reduce violence
CHICAGO --- Most psychiatric disorders - including depression -- do not predict future violent behavior, according to new Northwestern Medicine longitudinal study of delinquent youth. The only exception is substance abuse and dependence.
"Our findings are relevant to the recent tragic plane crash in the French Alps. Our findings show that no one could have predicted that the pilot - who apparently ...
PORTLAND, Ore. - A new study released today found that drugs used to treat multiple sclerosis have soared in price in the past two decades, in some cases more than 700 percent, even though newer drugs have come to the market - a process that normally should have stabilized or reduced the cost of at least the older medications.
There are no multiple sclerosis drugs now available in the United States with a list price below $50,000 a year, which is two to three times more than the price in Canada, Australia or the United Kingdom. The group of drugs available to treat this ...
When Microsoft released the Kinect for Xbox in November 2010, it transformed the video game industry. The most inexpensive 3-D camera to date, the Kinect bypassed the need for joysticks and controllers by sensing the user's gestures, leading to a feeling of total immersion into the game. Microsoft sold 8 million Kinect units within 60 days, making it the fastest-selling electronic device ever.
"But then something interesting happened," said Oliver Cossairt, assistant professor of electrical engineering and computer science at Northwestern University's McCormick School ...
Northwestern University scientists have developed the first liquid nanoscale laser. And it's tunable in real time, meaning you can quickly and simply produce different colors, a unique and useful feature. The laser technology could lead to practical applications, such as a new form of a "lab on a chip" for medical diagnostics.
To understand the concept, imagine a laser pointer whose color can be changed simply by changing the liquid inside it, instead of needing a different laser pointer for every desired color.
In addition to changing color in real time, the liquid ...
TORONTO, April 20, 2015-- Although National Comprehensive Cancer Network (NCCN) guidelines consider 18F-PET/CT (FDG PET/CT) appropriate for systemic staging of newly diagnosed stage III breast cancer, the technique may not be equally valuable for all breast cancer histologies. Researchers at the Memorial Sloan Kettering Cancer Center found that while FDG PET/CT is valuable for systemic staging of stage III ductal breast cancer, it adds little to the systemic staging of ILC.
"We are evaluating patient and disease factors that affect the value of FDG PET/CT for systemic ...
PULLMAN, Wash. - Text messaging that connects teens with sexual health educators is effective for delivering sexual health information, according to a recent study in The Edward R. Murrow College of Communication at Washington State University.
The research abstract is online and the work will appear in an upcoming print issue of the journal Health Education and Behavior.
"What we found is that teens identified as 'at-risk' use this text messaging service at a higher rate that other teens," said Jessica Willoughby, lead investigator on the project and an assistant professor ...
Children with hemophilia A require three to four infusions each week to prevent bleeding episodes, chronic pain and joint damage. The effect on quality of life can be significant, due to time and discomfort associated with infusions. For these reasons, under dosing is common, leaving children at increased risk for bleeding episodes and even death.
This extended half-life factor VIII enables patients to receive one or two infusions each week without an increased risk of bleeding. The first report on the safety and efficacy of this therapy in children under 12 years old ...
Ahmad M. Khalil, PhD, knew the odds were against him -- as in thousands upon thousands to one.
Yet he and his team never wavered from their quest to identify the parts of the body responsible for revving up one of the most aggressive forms of breast cancer, HER2+. This month in Breast Cancer Research and Treatment, Khalil and his colleagues at Case Western Reserve University proved the power of persistence; from a pool of more than 30,000 possibilities, they found 38 genes and molecules that most likely trigger HER2+ cancer cells to spread.
By narrowing what was once ...
TORONTO, April 24, 2015-- Preliminary results of a study of patients with prostate cancer show that MR tractography may be a reliable quantitative imaging biomarker to assess prostate cancer treatment response to androgen deprivation and radiation therapy, according to a team of researchers at Brigham and Women's Hospital and Massachusetts General Hospital in Boston. Quantitative evaluation shows higher tract densities after androgen deprivation and radiation therapy, reflecting gland shrinkage and subsequent fibrosis.
Twenty-two patients with elevated prostate-specific ...
Stem cells naturally cling to feeder cells as they grow in petri dishes. Scientists have thought for years that this attachment occurs because feeder cells serve as a support system, providing stems cells with essential nutrients.
But a new study that successfully grew stem cells with dead, or fixed, feeder cells suggests otherwise.
The discovery, described in the Journal of Materials Chemistry B, challenges the theory that feeder cells provide nutrients to growing stem cells. It also means that the relationship between the two cells is superficial, according to ...
