Magnetic resonance-guided interstitial therapy for vaginal recurrence of endometrial cancer

Akila N. Viswanathan, Robert Cormack, Caroline L. Holloway, Cynthia Tanaka, Desmond O'Farrell, Phillip M. Devlin, Clare Tempany

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the feasibility and to describe the acute toxicity of a real-time intraoperative magnetic resonance (MR)-image guided interstitial approach to treating vaginal recurrence of endometrial cancer. Methods and Materials: From February 2004 to April 2005, 10 patients with recurrent endometrial cancer underwent MR-guided interstitial brachytherapy. Parameters evaluated included needle placement, dose-volume histograms (DVH), and complications. Results: Magnetic resonance-image guidance resulted in accurate needle placement. Tumor DVH values included median volume, 47 cc; V100, 89%; V150, 61%; V200, 38%; D90, 71 Gy; and D100, 60 Gy. DVH of organs at risk resulted in a median D2cc of external beam and brachytherapy dose (% of brachytherapy prescription): bladder, 75Gy3 (88%); rectum, 70Gy3 (87%); and sigmoid, 56Gy3 (41%). All patients experienced either a Grade 1 or 2 acute toxicity related to the radiation; only 1 patient had Grade 3 toxicity. No toxicities were attributable to the use of MR guidance. Conclusions: Real-time MR guidance during the insertion of interstitial needles reduces the likelihood of an inadvertent insertion of the needles into the bladder and the rectum. Three-dimensional dosimetry allows estimation of the dose to organs at risk. Toxicities are limited.

Original languageEnglish (US)
Pages (from-to)91-99
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume66
Issue number1
DOIs
StatePublished - Sep 1 2006
Externally publishedYes

Keywords

  • Interstitial brachytherapy
  • Magnetic resonance
  • Recurrent endometrial cancer

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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