TY - JOUR
T1 - Confirmation of thermal dose as a predictor of local control in cervical carcinoma patients treated with state-of-the-art radiation therapy and hyperthermia
AU - Kroesen, Michiel
AU - Mulder, Hendrik T.
AU - van Holthe, Jeanette M. L.
AU - Aangeenbrug, Aleida A.
AU - Mens, Jan Willem M.
AU - van Doorn, Helena C.
AU - Paulides, Margarethus M.
AU - Oomen-de Hoop, Esther
AU - Vernhout, Rene M.
AU - Lutgens, Ludy C.
AU - van Rhoon, Gerard C.
AU - Franckena, Martine
N1 - Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/11
Y1 - 2019/11
N2 - Background: Addition of deep hyperthermia results in improved local control (LC) and overall survival (OS) compared to radiotherapy alone in patients with cervical carcinoma. Previously, we showed that the thermal dose of hyperthermia significantly correlates with LC and disease specific survival (DSS). Over the last decade, new radiation techniques were introduced resulting in improved LC.Aim: To validate the effect of thermal dose in a more recent cohort of patients treated with modern radiotherapy techniques, including image guided brachytherapy (IGBT).Methods: We analyzed primary cervical carcinoma patients treated with a combination of radiotherapy and deep hyperthermia between 2005 and 2016 at our institute. Data on patient, tumor and treatment were collected including the thermal dose parameters TRISE and CEM43T90. Follow-up data on LC, disease free survival, DSS, OS as well as late toxicity data were collected. Data were analyzed using the Cox proportional hazard and Kaplan-Meier analyses.Results: 227 patients were included. In multivariate analysis, histology, FIGO stage, lymphadenopathy, TRISE, CEM43T90 and IGBT had a significant effect on LC. In the patients treated with IGBT, the thermal dose parameter TRISE remained to have a significant effect on LC in univariate analysis.Conclusions: The positive association between thermal dose and clinical outcome is replicated in an independent, recent cohort of cervical carcinoma patients. Importantly, in patients receiving IGBT, the effect of thermal dose on clinical outcome is still observed. (C) 2019 Elsevier B.V. All rights reserved.
AB - Background: Addition of deep hyperthermia results in improved local control (LC) and overall survival (OS) compared to radiotherapy alone in patients with cervical carcinoma. Previously, we showed that the thermal dose of hyperthermia significantly correlates with LC and disease specific survival (DSS). Over the last decade, new radiation techniques were introduced resulting in improved LC.Aim: To validate the effect of thermal dose in a more recent cohort of patients treated with modern radiotherapy techniques, including image guided brachytherapy (IGBT).Methods: We analyzed primary cervical carcinoma patients treated with a combination of radiotherapy and deep hyperthermia between 2005 and 2016 at our institute. Data on patient, tumor and treatment were collected including the thermal dose parameters TRISE and CEM43T90. Follow-up data on LC, disease free survival, DSS, OS as well as late toxicity data were collected. Data were analyzed using the Cox proportional hazard and Kaplan-Meier analyses.Results: 227 patients were included. In multivariate analysis, histology, FIGO stage, lymphadenopathy, TRISE, CEM43T90 and IGBT had a significant effect on LC. In the patients treated with IGBT, the thermal dose parameter TRISE remained to have a significant effect on LC in univariate analysis.Conclusions: The positive association between thermal dose and clinical outcome is replicated in an independent, recent cohort of cervical carcinoma patients. Importantly, in patients receiving IGBT, the effect of thermal dose on clinical outcome is still observed. (C) 2019 Elsevier B.V. All rights reserved.
KW - Hyperthermia
KW - Cervical cancer
KW - Treatment outcome
KW - Thermal dose
KW - Trise
KW - CEM43T90
KW - Image guided brachytherapy
KW - GUIDED ADAPTIVE BRACHYTHERAPY
KW - CLINICAL IMPLEMENTATION
KW - REGIONAL HYPERTHERMIA
KW - DEEP HYPERTHERMIA
KW - RANDOMIZED-TRIAL
KW - CANCER
KW - RADIOTHERAPY
KW - TIME
KW - RADIOCHEMOTHERAPY
KW - TEMPERATURE
U2 - 10.1016/j.radonc.2019.06.021
DO - 10.1016/j.radonc.2019.06.021
M3 - Article
SN - 0167-8140
VL - 140
SP - 150
EP - 158
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -