title: Cervix cancer brachytherapy: high dose rate.
abstract: Cervical cancer, although less common in industrialized countries, is the fourth most common cancer affecting women worldwide and the fourth leading cause of cancer death. In developing countries, these cancers are often discovered at a later stage in the form of locally advanced tumour with a poor prognosis. Depending on the stage of the disease, treatment is mainly based on a chemoradiotherapy followed by uterovaginal brachytherapy ending by a potential remaining tumour surgery or in principle for some teams. The role of irradiation is crucial to ensure a better local control. It has been shown that the more the delivered dose is important, the better the local results are. In order to preserve the maximum of organs at risk and to allow this dose escalation, brachytherapy (intracavitary and/or interstitial) has been progressively introduced. Its evolution and its progressive improvement have led to the development of high dose rate brachytherapy, the advantages of which are especially based on the possibility of outpatient treatment while maintaining the effectiveness of other brachytherapy forms (i.e., low dose rate or pulsed dose rate). Numerous innovations have also been completed in the field of imaging, leading to a progress in treatment planning systems by switching from two-dimensional form to a three-dimensional one. Image-guided brachytherapy allows more precise target volume delineation as well as an optimized dosimetry permitting a better coverage of target volumes.
authors.affiliation: Service de radiothérapie, CHRU Morvan, 2, avenue Foch, 29609 Brest, France. Electronic address: petra.miglierini@chu-brest.fr.
authors.forename: P
authors.initials: P
authors.lastname: Miglierini
authors.affiliation: Service de radiothérapie, CHRU Morvan, 2, avenue Foch, 29609 Brest, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Malhaire
authors.affiliation: Service de radiothérapie, CHRU Morvan, 2, avenue Foch, 29609 Brest, France.
authors.forename: G
authors.initials: G
authors.lastname: Goasduff
authors.affiliation: Service de radiothérapie, CHRU Morvan, 2, avenue Foch, 29609 Brest, France.
authors.forename: O
authors.initials: O
authors.lastname: Miranda
authors.affiliation: Service de radiothérapie, CHRU Morvan, 2, avenue Foch, 29609 Brest, France.
authors.forename: O
authors.initials: O
authors.lastname: Pradier
mesh_terms: D000553:Ambulatory Care; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D004867:Equipment Design; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy; D058958:Organs at Risk; D017410:Practice Guidelines as Topic; D011832:Radiation Injuries / Q000517:prevention & control; D011835:Radiation Protection; D011868:Radioisotopes / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000532:radiotherapy* / Q000628:therapy
chemical_list: D011868:Radioisotopes
keywords: Brachytherapy; Cancer du col utérin; Cervix cancer; Curiethérapie; Haut débit de dose; High dose rate