TY  - JOUR
AB  - PURPOSE: Brachytherapy is a mandatory component of primary radiochemotherapy in cervical cancer. The dose can be applied with a traditional intracavitary approach (IC alone) or with multiple catheter brachytherapy to optimize dose distribution in an individual concept. We therefore evaluated whether the utilization of a tandem-ring applicator plus additional intracavitary applicators (add IC) provides an advantage over the traditional IC alone approach, as this method is less time consuming and less invasive compared to a combined intracavitary/interstitial brachytherapy. METHODS: Twenty three procedures of intracavitary brachytherapy for cervical cancer with additional intracavitary applicators performed in seven patients treated between 2016 and 2018 in our institution were included in this study. Plans were optimized for D90 HR-CTV with and without the utilization of the additional applicators and compared by statistical analysis. RESULTS: D90 for HR-CTV was 5.71 Gy (±1.17 Gy) for fractions optimized with add IC approach and 5.29 Gy (±1.24 Gy) for fractions without additional applicators (p < 0.01). This translates to a calculated mean EQD2 HR-CTV D90 of 80.72 Gy (±8.34 Gy) compared to 77.84 Gy (±8.49 Gy) after external beam therapy and four fractions of brachytherapy for add IC and IC alone, respectively (p < 0.01). The predictive value of improved coverage of HR-CTV in the first fraction was high. CONCLUSION: In a subgroup of cases, the addition of intracavitary Heyman capsules can be an alternative to interstitial brachytherapy to improve the plan quality compared to standard IC alone brachytherapy. The benefit from the addition of applicators in the first fraction is predictive for the following fractions.
AU  - Scharl, S.*
AU  - Hugo, C.*
AU  - Weidenbaecher, C.*
AU  - Bronger, H.*
AU  - Brambs, C.*
AU  - Kiechle, M.*
AU  - Makowski, M.R.*
AU  - Combs, S.E.
AU  - Schuettrumpf, L.*
C1  - 65399
C2  - 52287
SP  - 557-564
TI  - Intracavitary brachytherapy with additional Heyman capsules in the treatment of cervical cancer.
JO  - Arch Gynecol Obstet
VL  - 307
IS  - 2
PY  - 2023
SN  - 0932-0067
ER  - 

TY  - JOUR
AB  - Purpose: PET-CT has recently been included in the NCCN staging recommendations for cervical cancer stages II–IV and is already routinely applied to radiotherapy planning for other malignancies, as it is expected to provide higher accuracy for the detection of areas with tumor cell spread. In this study, we report on our first experiences of PET-based radiotherapy planning for cervical cancer. Methods: 19 patients with cervical cancer that underwent pre-therapeutic PET imaging treated at our institution between January 2016 and April 2019 were included in the study. Information on the primary tumor, lymph node involvement, metastatic spread and changes in the radiotherapy procedure based on the PET findings are described. Results: A previously unknown primary tumor extension that was detected by PET imaging in one patient. In patients who underwent a PET before the systematic pelvic and paraaortic lymphonodectomy (n = 2), PET was false negative for pelvic lymph node metastases in 50%. In patients who underwent a PET after the systematic LNE (n = 13), additional lymph node metastases were detected in seven patients (53.80%). Distant metastases were suspected in three patients (15.7%) based on PET imaging. The suspicion was confirmed in one patient (peritoneal spread) and excluded in two patients (supra-diaphragmatic lymph nodes). In 13 patients (68.4%), RT procedures were altered due to findings in PET imaging. Conclusion: PET-based radiochemotherapy planning may improve control rates by identifying areas of tumor cell spread eligible for dose escalation. False positivity, however, should be excluded in patients with findings that lead to major modifications of the therapeutic strategy.
AU  - Scharl, S.*
AU  - Weidenbaecher, C.B.*
AU  - Hugo, C.*
AU  - Brambs, C.E.*
AU  - Knorr, K.*
AU  - Combs, S.E.
AU  - Schüttrumpf, L.*
C1  - 64576
C2  - 52332
CY  - Tiergartenstrasse 17, D-69121 Heidelberg, Germany
SP  - 1821-1828
TI  - First experiences with PET-MRI/CT in radiotherapy planning for cervical cancer.
JO  - Arch Gynecol Obstet
VL  - 306
IS  - 5
PB  - Springer Heidelberg
PY  - 2022
SN  - 0932-0067
ER  - 

TY  - JOUR
AU  - Neu, E.
AU  - Michailov, M.C.
AU  - Ernst, G.D.S.
AU  - Staehler, G.
C1  - 42147
C2  - 38200
SP  - 496-497
TI  - Vasomotorische Reaktionen bei menschlichen Genitalgefäßen auf Röntgenstrahlung und Thermostimulation.
JO  - Arch Gynecol Obstet
VL  - 245
IS  - 1-4
PY  - 1989
SN  - 0932-0067
ER  -