Cargando…

Variation in uterus position prior to brachytherapy of the cervix: A case report

Rationale: brachytherapy is administered in the treatment of patients with locally advanced cervical cancer following chemoradiotherapy. Lack of local anatomy evaluation prior to this procedure might lead to the selection of an inappropriate brachytherapy applicator, increasing the risk of side effe...

Descripción completa

Detalles Bibliográficos
Autores principales: Georgescu, MT, Anghel, R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Carol Davila University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304382/
https://www.ncbi.nlm.nih.gov/pubmed/28255386
_version_ 1782506874953793536
author Georgescu, MT
Anghel, R
author_facet Georgescu, MT
Anghel, R
author_sort Georgescu, MT
collection PubMed
description Rationale: brachytherapy is administered in the treatment of patients with locally advanced cervical cancer following chemoradiotherapy. Lack of local anatomy evaluation prior to this procedure might lead to the selection of an inappropriate brachytherapy applicator, increasing the risk of side effects (e.g. uterus perforation, painful procedure ...). Objective: To assess the movement of the uterus and cervix prior to brachytherapy in patients with gynecological cancer, in order to select the proper type of brachytherapy applicator. Also we wanted to promote the replacement of the plain X-ray brachytherapy with the image-guided procedure. Methods and results: We presented the case of a 41-year-old female diagnosed with a biopsy that was proven cervical cancer stage IIIB. At diagnosis, the imaging studies identified an anteverted uterus. The patient underwent preoperative chemoradiotherapy. Prior to brachytherapy, the patient underwent a pelvic magnetic resonance imaging (MRI), which identified a displacement of the uterus in the retroverted position. Discussion: A great variety of brachytherapy applicators is available nowadays. Major changes in uterus position and lack of evaluation prior to brachytherapy might lead to a higher rate of incidents during this procedure. Also, by using orthogonal simulation and bidimensional (2D) treatment planning, brachytherapy would undoubtedly fail to treat the remaining tumoral tissue. This is the reason why we proposed the implementation of a prior imaging of the uterus and computed tomography (CT)/ MRI-based simulation in the brachytherapy procedure. Abbreviations: MRI = magnetic resonance imaging, CT = computed tomography, CTV = clinical target volume, DVH = dose-volume histogram, EBRT = external beam radiotherapy, GTV = gross tumor volume, Gy = Gray (unit), ICRU = International Commission of Radiation Units, IGRT = image guided radiotherapy, IM = internal margin, IMRT = image modulated radiotherapy, ITV = internal target volume, MRI = magnetic resonance imaging, OAR = organs at risk, PTV = planning target volume, QUANTEC = Quantitative Analyses of Normal Tissue Effects in the Clinic
format Online
Article
Text
id pubmed-5304382
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Carol Davila University Press
record_format MEDLINE/PubMed
spelling pubmed-53043822017-03-02 Variation in uterus position prior to brachytherapy of the cervix: A case report Georgescu, MT Anghel, R J Med Life Case Presentations Rationale: brachytherapy is administered in the treatment of patients with locally advanced cervical cancer following chemoradiotherapy. Lack of local anatomy evaluation prior to this procedure might lead to the selection of an inappropriate brachytherapy applicator, increasing the risk of side effects (e.g. uterus perforation, painful procedure ...). Objective: To assess the movement of the uterus and cervix prior to brachytherapy in patients with gynecological cancer, in order to select the proper type of brachytherapy applicator. Also we wanted to promote the replacement of the plain X-ray brachytherapy with the image-guided procedure. Methods and results: We presented the case of a 41-year-old female diagnosed with a biopsy that was proven cervical cancer stage IIIB. At diagnosis, the imaging studies identified an anteverted uterus. The patient underwent preoperative chemoradiotherapy. Prior to brachytherapy, the patient underwent a pelvic magnetic resonance imaging (MRI), which identified a displacement of the uterus in the retroverted position. Discussion: A great variety of brachytherapy applicators is available nowadays. Major changes in uterus position and lack of evaluation prior to brachytherapy might lead to a higher rate of incidents during this procedure. Also, by using orthogonal simulation and bidimensional (2D) treatment planning, brachytherapy would undoubtedly fail to treat the remaining tumoral tissue. This is the reason why we proposed the implementation of a prior imaging of the uterus and computed tomography (CT)/ MRI-based simulation in the brachytherapy procedure. Abbreviations: MRI = magnetic resonance imaging, CT = computed tomography, CTV = clinical target volume, DVH = dose-volume histogram, EBRT = external beam radiotherapy, GTV = gross tumor volume, Gy = Gray (unit), ICRU = International Commission of Radiation Units, IGRT = image guided radiotherapy, IM = internal margin, IMRT = image modulated radiotherapy, ITV = internal target volume, MRI = magnetic resonance imaging, OAR = organs at risk, PTV = planning target volume, QUANTEC = Quantitative Analyses of Normal Tissue Effects in the Clinic Carol Davila University Press 2017 /pmc/articles/PMC5304382/ /pubmed/28255386 Text en ©Carol Davila University Press This article is distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0/), which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Case Presentations
Georgescu, MT
Anghel, R
Variation in uterus position prior to brachytherapy of the cervix: A case report
title Variation in uterus position prior to brachytherapy of the cervix: A case report
title_full Variation in uterus position prior to brachytherapy of the cervix: A case report
title_fullStr Variation in uterus position prior to brachytherapy of the cervix: A case report
title_full_unstemmed Variation in uterus position prior to brachytherapy of the cervix: A case report
title_short Variation in uterus position prior to brachytherapy of the cervix: A case report
title_sort variation in uterus position prior to brachytherapy of the cervix: a case report
topic Case Presentations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304382/
https://www.ncbi.nlm.nih.gov/pubmed/28255386
work_keys_str_mv AT georgescumt variationinuteruspositionpriortobrachytherapyofthecervixacasereport
AT anghelr variationinuteruspositionpriortobrachytherapyofthecervixacasereport