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  • A769662 br Primary tumour volume reduction during EBRT is

    2020-08-30


    Primary tumour volume reduction during EBRT is, and ADC in-crease during EBRT might be, a good predictor for regional and distant control; however their relation is not fully clarified. Perhaps it is the tumour biology of the primary tumours and the lymph node metastasis and their response to treatment that link both outcomes. Therefore, other interventional strategies might be considered for patients with a higher risk of regional or distant recurrence, such as a higher dose to distant lesions which should always be applied with great caution. In conclusion, as for primary tumours in the cervix, ADC values of affected nodes increase during EBRT. ADC values can be obtained from delineated volumes of primary tumour on T2 weighted MR unless there are substantial shifts between ADC mapping and T2 signal. Evaluation of ΔADC for primary tumours and affected lymph nodes might help to better predict response to EBRT and disease outcome. This study is in line with available evidence that volume reduction of the primary cervical tumour during EBRT is a prognostic factor for relapse.
    Conflicts of interest
    Cornelis van den Berg is a minority share holder of MRCode BV. The other authors declare that there are no conflicts of interest.
    Role of funding source
    The authors declare that no study sponsors were involved.
    Acknowledgements
    We kindly acknowledge Simon Woodings, medical physicist at the Department of Radiation Oncology of the University Medical Centre Utrecht, for his thorough revisions and support.
    Appendix A. Supplementary data
    References
    [2] Lim K, Small W, Portelance L, Creutzberg C, Jürgenliemk-Schulz IM, Mundt A, et al. Consensus guidelines for delineation of clinical target volume for intensity-modu-lated pelvic radiotherapy for the definitive treatment of A769662 cancer. Int J Radiat Oncol Biol Phys 2011;79:348–55. https://doi.org/10.1016/j.ijrobp.2009.10.075. [3] van de Bunt L, van der Heide UA, Ketelaars M, de Kort GAP, Jürgenliemk-Schulz IM. Conventional, conformal, and intensity-modulated radiation therapy treatment planning of external beam radiotherapy for cervical cancer: The impact of tumor regression. Int J Radiat Oncol Biol Phys 2006;64:189–96. https://doi.org/10.1016/ j.ijrobp.2005.04.025.
    [5] Sturdza A, Pötter R, Fokdal LU, Haie-Meder C, Tan LT, Mazeron R, et al. Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study. Radiother Oncol 2016;120:428–33. https://doi.org/10.1016/j.radonc.2016.03.011. [6] Nomden CN, De Leeuw AAC, Roesink JM, Tersteeg RJHA, Moerland MA, Witteveen PO, et al. Clinical outcome and dosimetric parameters of chemo-radiation including MRI guided adaptive brachytherapy with tandem-ovoid applicators for cervical cancer patients: A single institution experience. Radiother Oncol 2013;107:69–74. https://doi.org/10.1016/j.radonc.2013.04.006.
    [9] Pötter R, Haie-Meder C, Van Limbergen E, Barillot I, De Brabandere M, Dimopoulos J, et al. Recommendations from gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiother Oncol 2006;78:67–77. https://doi.org/
    [10] Haie-Meder C, Pötter R, Van Limbergen E, Briot E, De Brabandere M, Dimopoulos J, et al. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol 2005;74:235–45. https://doi.org/10.1016/j.radonc.2004.12.015. [11] Tanderup K, Fokdal LU, Sturdza A, Haie-Meder C, Mazeron R, van Limbergen E, et al. Effect of tumor dose, volume and overall treatment time on local control after radiochemotherapy including MRI guided brachytherapy of locally advanced cer-vical cancer. Radiother Oncol 2016;120:441–6. https://doi.org/10.1016/j.radonc. 2016.05.014.
    [12] Pötter R, Georg P, Dimopoulos JC, Grimm M, Berger D, Nesvacil N, et al. Clinical outcome of protocol based image (MRI) guided adaptive brachytherapy combined with 3D conformal radiotherapy with or without chemotherapy in patients with locally advanced cervical cancer. Radiother Oncol 2011;100:116–23. https://doi. org/10.1016/j.radonc.2011.07.012.
    [31] Yoon MS, Nam T-K, Chung W-K, Jeong SY, Ahn S-J, Nah B-S, et al. Metabolic re-sponse of pelvic and para-aortic lymph nodes during radiotherapy for carcinoma of the uterine cervix: using positron emission tomography/computed tomography. Int J Gynecol Cancer 2011;21:699–705. https://doi.org/10.1111/IGC.