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Magnetic resonance imaging response in patients treated with definitive radiation therapy for medically inoperable endometrial cancer-Does it predict treatment response?
- Source :
- Brachytherapy. 18(4)
- Publication Year :
- 2018
-
Abstract
- Purpose Many patients with endometrial cancer cannot undergo surgery and instead receive definitive radiation therapy (RT). We investigate the correlation between MRI response to RT and clinical outcomes. Methods and Materials Women with inoperable, clinical Stage I endometrial cancer were treated with definitive brachytherapy (BT) with/without pelvic RT (PRT). Patients underwent MRI with functional diffusion-weighted imaging before and after RT. A radiologist retrospectively classified cases as complete, partial, or indeterminate response (CR, PR, or IR, respectively) vs. disease progression. Local control was clinicopathologically defined. Results From 2007 to 2017, 50 women underwent definitive RT. Thirty-five (70%) received BT alone (median dose 37.5 Gy). For combined therapy, the median PRT and BT doses were 45 and 25 Gy, respectively. Median gross tumor volume and high-risk clinical target volume were 7.1 cc and 90.0 cc, respectively. Median followup among living patients was 20 months. All patients underwent post-RT MRI with T1/T2 sequencing at a median of 3.2 months after RT; 40 patients (80%) underwent functional diffusion-weighted imaging sequences. On initial post-RT MRI, CR was documented in 42 patients (84%), IR in 1 patient (2%), and PR in seven patients (14%). At median followup of 16.3 months, no CR patients had uterine failure. Among eight patients with initial PR/IR, all were found to be clinicopathologically no evidence of disease at the uterus on further evaluation. Conclusions Definitive RT with BT or BT + PRT is associated with high response rates on MRI. Overall, initial CR predicted for excellent outcome with no infield failure.
- Subjects :
- Adult
medicine.medical_specialty
Treatment response
medicine.medical_treatment
Brachytherapy
Uterus
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
medicine
Humans
Radiology, Nuclear Medicine and imaging
In patient
Medically inoperable
Aged
Retrospective Studies
Aged, 80 and over
medicine.diagnostic_test
business.industry
Endometrial cancer
Radiotherapy Planning, Computer-Assisted
Magnetic resonance imaging
Radiotherapy Dosage
Middle Aged
medicine.disease
Definitive Radiation Therapy
Endometrial Neoplasms
medicine.anatomical_structure
Diffusion Magnetic Resonance Imaging
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
Disease Progression
Female
Radiology
Neoplasm Recurrence, Local
business
Subjects
Details
- ISSN :
- 18731449
- Volume :
- 18
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Brachytherapy
- Accession number :
- edsair.doi.dedup.....e2a0f2efab334b731d050bbf7424ed34