[Brachytherapy in cervix cancers: development of techniques and concepts]

Cancer Radiother. 2003 Feb;7(1):42-9. doi: 10.1016/s1278-3218(02)00282-2.
[Article in French]

Abstract

Brachytherapy plays an important role in the treatment of patients with cervical carcinoma. Technical modalities have evolved during the last years and have benefited from imaging modalities development, specially MRI. Imaging modalities contribute to a better knowledge of tumoral extension and critical organs. Ultrasound during brachytherapy has led to the almost complete eradication of uterine perforation. In the future, a more systematic use of systems allowing optimization may induce a better dose distribution in the tumor as well as in the critical organs. Recent data provided information in favor of a better analysis in the relative role of dose-rate, total dose and treated volume and their influence on the local control and complication incidence. Concomitant radiochemotherapy represents a standard in the treatment of patients with tumoral size exceeding 4 cm. Some questions still remain: is concomitant chemotherapy of benefit during brachytherapy? Is there any place for complementary surgery, specially in patients with complete response after external irradiation with concomitant chemotherapy and brachytherapy? In order to answer the former question, a phase III randomized trial is going to start, with the Fédération Nationale des Centres de Lutte Contre le Cancer as a promoter.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Brachytherapy / adverse effects
  • Brachytherapy / instrumentation
  • Brachytherapy / methods
  • Brachytherapy / trends*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / surgery
  • Combined Modality Therapy
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Radiation Injuries / etiology
  • Radiation Injuries / prevention & control
  • Radioisotope Teletherapy
  • Radiotherapy Dosage
  • Survival Rate
  • Treatment Outcome
  • Ultrasonography
  • Uterine Cervical Neoplasms / diagnostic imaging
  • Uterine Cervical Neoplasms / drug therapy
  • Uterine Cervical Neoplasms / radiotherapy*
  • Uterine Cervical Neoplasms / surgery
  • Uterine Perforation / etiology
  • Uterine Perforation / prevention & control

Substances

  • Antineoplastic Agents