التفاصيل البيبلوغرافية
| العنوان: |
Role of Brachytherapy in the Postoperative Management of Endometrial Cancer: Decision-Making Analysis among Experienced European Radiation Oncologists |
| المؤلفون: |
Markus Glatzer, Kari Tanderup, Angeles Rovirosa, Lars Fokdal, Claudia Ordeanu, Luca Tagliaferri, Cyrus Chargari, Vratislav Strnad, Johannes Athanasios Dimopoulos, Barbara Šegedin, Rachel Cooper, Esten Søndrol Nakken, Primoz Petric, Elzbieta van der Steen-Banasik, Kristina Lössl, Ina M. Jürgenliemk-Schulz, Peter Niehoff, Ruth S. Hermansson, Remi A. Nout, Paul Martin Putora, Ludwig Plasswilm, Nikolaos Tselis |
| المصدر: |
Cancers; Volume 14; Issue 4; Pages: 906 |
| بيانات النشر: |
Multidisciplinary Digital Publishing Institute |
| سنة النشر: |
2022 |
| المجموعة: |
MDPI Open Access Publishing |
| مصطلحات موضوعية: |
decision-making, endometrial cancer, brachytherapy, decision tree |
| الوصف: |
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 ... |
| نوع الوثيقة: |
text |
| وصف الملف: |
application/pdf |
| اللغة: |
English |
| Relation: |
https://dx.doi.org/10.3390/cancers14040906 |
| DOI: |
10.3390/cancers14040906 |
| الاتاحة: |
https://doi.org/10.3390/cancers14040906 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| رقم الانضمام: |
edsbas.12CD5EF7 |
| قاعدة البيانات: |
BASE |