Zurück zur Übersicht
| Clinical and translational radiation oncology. 2018 Jan 11. doi: 10.1016/j.ctro.2018.01.001. pii: S2405-6308(17)30075-7. pmc: PMC5862686 |
| The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies. |
| Pötter R1, Tanderup K2, Kirisits C3, de Leeuw A4, Kirchheiner K5, Nout R6, Tan LT7, Haie-Meder C8, Mahantshetty U9, Segedin B10, Hoskin P11, Bruheim K12, Rai B13, Huang F14, Van Limbergen E15, Schmid M16, Nesvacil N17, Sturdza A18, Fokdal L19, Jensen NBK20, Georg D21, Assenholt M22, Seppenwoolde Y23, Nomden C24, Fortin I25, Chopra S26, van der Heide U27, Rumpold T28, Lindegaard JC29, Jürgenliemk-Schulz I30 |
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Abstract The publication of the GEC-ESTRO recommendations one decade ago was a significant step forward for reaching international consensus on adaptive target definition and dose reporting in image guided adaptive brachytherapy (IGABT) in locally advanced cervical cancer. Since then, IGABT has been spreading, particularly in Europe, North America and Asia, and the guidelines have proved their broad acceptance and applicability in clinical practice. However, a unified approach to volume contouring and reporting does not imply a unified administration of treatment, and currently both external beam radiotherapy (EBRT) and IGABT are delivered using a large variety of techniques and prescription/fractionation schedules. With IGABT, local control is excellent in limited and well-responding tumours. The major challenges are currently loco-regional control in advanced tumours, treatment-related morbidity, and distant metastatic disease. Emerging evidence from the RetroEMBRACE and EMBRACE I studies has demonstrated that clinical outcome is related to dose prescription and technique. The next logical step is to demonstrate excellent clinical outcome with the most advanced EBRT and brachytherapy techniques based on an evidence-based prospective dose and volume prescription protocol. The EMBRACE II study is an interventional and observational multicentre study which aims to benchmark a high level of local, nodal and systemic control while limiting morbidity, using state of the art treatment including an advanced target volume selection and contouring protocol for EBRT and brachytherapy, a multi-parametric brachytherapy dose prescription protocol (clinical validation of dose constraints), and use of advanced EBRT (IMRT and IGRT) and brachytherapy (IC/IS) techniques (clinical validation). The study also incorporates translational research including imaging and tissue biomarkers. |
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KEYWORDS: Adaptive radiotherapy, Brachytherapy, Cervix cancer, Local control, MRI guided radiotherapy, Morbidity |
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Publikations ID: 29594251 Quelle: öffnen |
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