[Can stereotactic body radiotherapy replace brachytherapy for locally advanced cervical cancer? French society for radiation oncology statement].
Fiche publication
Date publication
août 2020
Journal
Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique
Auteurs
Membres identifiés du Cancéropôle Est :
Pr PEIFFERT Didier
Tous les auteurs :
Chargari C, Renard S, Espenel S, Escande A, Buchheit I, Ducassou A, Peiffert D, Hannoun-Lévi JM
Lien Pubmed
Résumé
Brachytherapy is part of the treatment of locally advanced cervical cancers, accounting for about half of the total delivered dose. The benefit of dose escalation is the most important in advanced cases or if the tumor has responded poorly. The use of interstitial implantations makes it possible to reach doses of the order of 85 to 90Gy (including external beam radiotherapy contribution) in most patients, through image-guided approaches. Brachytherapy delivery is one of the quality criteria for patient care. To date, no data allow us to consider as an alternative the use of external boost through intensity-modulated or stereotactic body radiotherapy. Indeed, the doses delivered to the tumor and the capacity to spare normal tissues remains lower, as compared to what is permitted by brachytherapy. It is therefore appropriate for centers that do not have access to the technique to establish networks with centers where brachytherapy is performed, to allow each patient to have access to the technique. It is also necessary to promote brachytherapy teaching. The issue of reimbursement will be crucial in the coming years to maintain expertise that is today insufficiently valued in its financial aspects, but has a very high added value for patients.
Mots clés
Brachytherapy, Cancer du col utérin, Cervical cancer, Curiethérapie, Intensity-modulated radiotherapy, Radiothérapie avec modulation d’intensité, Radiothérapie stéréotaxique, Stereotactic body radiotherapy
Référence
Cancer Radiother. 2020 Aug 1;: