Role of Brachytherapy in the Postoperative Management of Endometrial Cancer: Decision-Making Analysis among Experienced European Radiation Oncologists

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Role of Brachytherapy in the Postoperative Management of Endometrial Cancer : Decision-Making Analysis among Experienced European Radiation Oncologists

Glatzer, Markus (författare): Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland

Tanderup, Kari (författare): Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

Rovirosa, Angeles (författare): Department of Radiation Oncology, Hospital Clinic Barcelona, Barcelona, Spain; Fonaments Clinics Department, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain

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Fokdal, Lars (författare): Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

Ordeanu, Claudia (författare): Department of Radiotherapy, Institute of Oncology "Prof. Dr. Ion Chiricuta", Cluj-Napoca, Romania

Tagliaferri, Luca (författare): Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy

Chargari, Cyrus (författare): Department of Radiation Oncology, Gustave Roussy Comprehensive Cancer Center, Paris, France

Strnad, Vratislav (författare): Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany

Dimopoulos, Johannes Athanasios (författare): Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Šegedin, Barbara (författare): Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

Cooper, Rachel (författare): Radiotherapy Research Group, Leeds Cancer Centre, St. Jame's University Hospital, Leeds, UK

Nakken, Esten Søndrol (författare): Department of Oncology, Oslo University Hospital, Oslo, Norway

Petric, Primoz (författare): Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland

van der Steen-Banasik, Elzbieta (författare): Department of Radiotherapy, Radiotherapiegroep Arnhem, Arnhem, The Netherlands

Lössl, Kristina (författare): Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

Jürgenliemk-Schulz, Ina M (författare): Department of Radiation Oncology, Cancer Center, University Medical Center Utrecht, AB Utrecht, The Netherlands

Niehoff, Peter (författare): Department of Radiation Oncology, Sana Klinikum Offenbach GmbH, Offenbach, Germany

Hermansson, Ruth S. (författare): Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Oncology

Nout, Remi A. (författare): Department of Radiotherapy, Erasmus MC Cancer Institute, CA Rotterdam, The Netherlands

Putora, Paul Martin (författare): Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

Plasswilm, Ludwig (författare): Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

Tselis, Nikolaos (författare): Klinik für Strahlentherapie und Onkologie, Universitätsklinikum Frankfurt, Goethe Universität, Frankfurt, Germany

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Department of Radiation Oncology, Kantonsspital St Gallen, St. Gallen, Switzerland Department of Oncology, Aarhus University Hospital, Aarhus, Denmark (creator_code:org_t)

2022-02-11
2022
Engelska.
Ingår i: Cancers. - : MDPI. - 2072-6694. ; 14:4

Relaterad länk:: https://doi.org/10.3...; visa fler...; https://www.mdpi.com...; https://urn.kb.se/re...; https://doi.org/10.3...; visa färre...

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BACKGROUND: There are various society-specific guidelines addressing adjuvant brachytherapy (BT) after surgery for endometrial cancer (EC). However, these recommendations are not uniform. Against this background, clinicians need to make decisions despite gaps between best scientific evidence and clinical practice. We explored factors influencing decision-making for adjuvant BT in clinical routine among experienced European radiation oncologists in the field of gynaecological radiotherapy (RT). We also investigated the dose and technique of BT.METHODS: Nineteen European experts for gynaecological BT selected by the Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology provided their decision criteria and technique for postoperative RT in EC. The decision criteria were captured and converted into decision trees, and consensus and dissent were evaluated based on the objective consensus methodology.RESULTS: The decision criteria used by the experts were tumour extension, grading, nodal status, lymphovascular invasion, and cervical stroma/vaginal invasion (yes/no). No expert recommended adjuvant BT for pT1a G1-2 EC without substantial LVSI. Eighty-four percent of experts recommended BT for pT1a G3 EC without substantial LVSI. Up to 74% of experts used adjuvant BT for pT1b LVSI-negative and pT2 G1-2 LVSI-negative disease. For 74-84% of experts, EBRT + BT was the treatment of choice for nodal-positive pT2 disease and for pT3 EC with cervical/vaginal invasion. For all other tumour stages, there was no clear consensus for adjuvant treatment. Four experts already used molecular markers for decision-making. Sixty-five percent of experts recommended fractionation regimens of 3 × 7 Gy or 4 × 5 Gy for BT as monotherapy and 2 × 5 Gy for combination with EBRT. The most commonly used applicator for BT was a vaginal cylinder; 82% recommended image-guided BT.CONCLUSIONS: There was a clear trend towards adjuvant BT for stage IA G3, stage IB, and stage II G1-2 LVSI-negative EC. Likewise, there was a non-uniform pattern for BT dose prescription but a clear trend towards 3D image-based BT. Finally, molecular characteristics were already used in daily decision-making by some experts under the pretext that upcoming trials will bring more clarity to this topic.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

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Av lärosätet: Örebro universitet

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Role of Brachytherapy in the Postoperative Management of Endometrial Cancer : Decision-Making Analysis among Experienced European Radiation Oncologists

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