The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies

被引：516

作者：

Potter, Richard ^{[1
,18
]}

Tanderup, Kari ^{[2
]}

Kirisits, Christian ^{[1
,18
]}

de Leeuw, Astrid ^{[3
,20
]}

Kirchheiner, Kathrin ^{[1
]}

Nout, Remi ^{[4
]}

Tan, Li Tee ^{[5
,6
,31
]}

Haie-Meder, Christine ^{[7
,17
]}

Mahantshetty, Umesh ^{[8
]}

Segedin, Barbara ^{[9
,21
]}

Hoskin, Peter ^{[10
,19
]}

Bruheim, Kjersti ^{[11
,22
]}

Rai, Bhavana ^{[12
]}

Huang, Fleur ^{[13
,23
,24
]}

Van Limbergen, Erik ^{[14
,26
]}

Schmid, Max ^{[1
]}

Nesvacil, Nicole ^{[1
]}

Sturdza, Alina ^{[1
,18
]}

Fokdal, Lars ^{[2
]}

Jensen, Nina Boje Kibsgaard ^{[2
]}

Georg, Dietmar ^{[1
]}

Assenholt, Marianne ^{[2
]}

Seppenwoolde, Yvette ^{[1
]}

Nomden, Christel ^{[3
]}

Fortin, Israel ^{[1
,16
]}

Chopra, Supriya ^{[8
]}

van der Heide, Uulke ^{[15
]}

Rumpold, Tamara ^{[1
]}

Lindegaard, Jacob Christian ^{[2
]}

Jurgenliemk-Schulz, Ina ^{[3
,20
]}

Dumas, Isabelle ^{[17
]}

Chargari, Cyrus ^{[17
]}

Swamidas, Jamema ^{[8
]}

Shrivastava, Shyam Kishore ^{[8
]}

Lowe, Gerry ^{[19
]}

Hudej, Robert ^{[21
]}

Hellebust, Taran Paulsen ^{[22
]}

Menon, Geetha ^{[23
,24
]}

Oinam, Arun S. ^{[12
]}

Cooper, Rachel ^{[25
]}

Bownes, Peter ^{[25
]}

Banasik, Elzbieta Van der Steen ^{[27
]}

Sundset, Marit ^{[28
,29
]}

Pieters, Bradley ^{[30
]}

Lutgens, Ludy C. H. W. ^{[32
]}

Villafranca, Elena ^{[33
]}

Hadjiev, Janaki ^{[34
]}

Bachand, Francois ^{[35
]}

Erickson, Beth ^{[36
]}

Jacobson, Geraldine ^{[37
]}

机构：

[1] Med Univ Vienna, Dept Radiat Oncol, Comprehens Canc Ctr, Christian Doppler Lab Med Radiat Res Radiat Oncol, Vienna, Austria

[2] Aarhus Univ Hosp, Dept Oncol, DK-8000 Aarhus C, Denmark

[3] Univ Med Ctr Utrecht, Dept Radiat Oncol, Utrecht, Netherlands

[4] Leiden Univ, Dept Radiat Oncol, Med Ctr, Leiden, Netherlands

[5] Cambridge Univ Hosp Natl Hlth Serv Trust, Addenbrookes Hosp, Dept Oncol, Cambridge, England

[6] Cambridge Univ Hosp Natl Hlth Serv Trust, Addenbrookes Hosp, Dept Radiol & Gynae Oncol, Cambridge, England

[7] Radiat Oncol Dept, Gustave Roussy Canc Campus Grand Paris, Paris, France

[8] Tata Mem Hosp, Dept Radiat Oncol, Mumbai, India

[9] Inst Oncol, Dept Radiat Oncol, Ljubljana, Slovenia

[10] Mt Vernon Canc Ctr, Canc Ctr, Northwood, Middx, England

[11] Oslo Univ Hosp, Dept Oncol, Oslo, Norway

[12] Postgrad Inst Med Educ & Res, Dept Radiotherapy & Oncol, Chandigarh, India

[13] Univ Alberta, Cross Canc Inst, Dept Oncol, Edmonton, AB, Canada

[14] Univ Hosp Gasthuisberg, Dept Radiat Oncol, Leuven, Belgium

[15] Netherlands Canc Inst, Dept Radiat Oncol, Amsterdam, Netherlands

[16] Univ Montreal, Dept Radiat Oncol, Ctr Hosp Univ Montreal, Montreal, PQ, Canada

[17] Gustave Roussy, Dept Radiotherapy, Villejuif, France

[18] Med Univ Vienna, Gen Hosp Vienna, Dept Radiat Oncol, Comprehens Canc Ctr, Vienna, Austria

[19] Mt Vernon Hosp, Canc Ctr, London, England

[20] Univ Med Ctr Utrecht, Dept Radiat Oncol, Utrecht, Netherlands

[21] Inst Oncol Ljubljana, Dept Radiotherapy, Ljubljana, Slovenia

[22] Oslo Univ Hosp, Norwegian Radium Hosp, Dept Oncol, Oslo, Norway

[23] Cross Canc Inst, Dept Oncol, Edmonton, AB, Canada

[24] Univ Alberta, Edmonton, AB, Canada

[25] St James Univ Hosp, Leeds Canc Ctr, Leeds, W Yorkshire, England

[26] UZ Leuven, Dept Radiat Oncol, Leuven, Belgium

[27] Dept Radiotherapy, Arnhem, Netherlands

[28] St Olavs Hosp, Clin Oncol, Trondheim, Norway

[29] St Olavs Hosp, Womens Clin, Trondheim, Norway

[30] Univ Amsterdam, Acad Med Ctr, Dept Radiat Oncol, Amsterdam, Netherlands

[31] Cambridge Univ Hosp NHS Founda tion Trust, Addenbrookes Hosp, Oncol Ctr, Cambridge, England

[32] Maastricht Radiat Oncol MAASTRO Clin, Maastricht, Netherlands

[33] Hosp Navarra, Dept Radiat Oncol, Pamplona, Spain

[34] Univ Kaposvar, Dept Oncoradiol, Hlth Sci Ctr, Kaposvar, Hungary

[35] British Columbia Canc Agcy, Dept Radiat Oncol, Vancouver, BC, Canada

[36] Med Coll Wisconsins, Dept Radiat Oncol, Milwaukee, WI USA

[37] Univ Iowa, Dept Radiat Oncol, Iowa City, IA 52242 USA

[38] Kuopio Univ Hosp, Dept Obstet & Gynecol, Kuopio, Finland

来源：

CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY | 2018年 / 9卷

关键词：

Cervix cancer; Brachytherapy; Adaptive radiotherapy; MRI guided radiotherapy; Local control; Morbidity;

D O I：

10.1016/j.ctro.2018.01.001

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

The publication of the GEC-ESTRO recommendations one decade ago was a significant step forward for reaching international consensus on adaptive target definition and dose reporting in image guided adaptive brachytherapy (IGABT) in locally advanced cervical cancer. Since then, IGABT has been spreading, particularly in Europe, North America and Asia, and the guidelines have proved their broad acceptance and applicability in clinical practice. However, a unified approach to volume contouring and reporting does not imply a unified administration of treatment, and currently both external beam radiotherapy (EBRT) and IGABT are delivered using a large variety of techniques and prescription/fractionation schedules. With IGABT, local control is excellent in limited and well-responding tumours. The major challenges are currently loco-regional control in advanced tumours, treatment-related morbidity, and distant metastatic disease. Emerging evidence from the RetroEMBRACE and EMBRACE I studies has demonstrated that clinical outcome is related to dose prescription and technique. The next logical step is to demonstrate excellent clinical outcome with the most advanced EBRT and brachytherapy techniques based on an evidence-based prospective dose and volume prescription protocol. The EMBRACE II study is an interventional and observational multicentre study which aims to benchmark a high level of local, nodal and systemic control while limiting morbidity, using state of the art treatment including an advanced target volume selection and contouring protocol for EBRT and brachytherapy, a multi-parametric brachytherapy dose prescription protocol (clinical validation of dose constraints), and use of advanced EBRT (IMRT and IGRT) and brachytherapy (IC/IS) techniques (clinical validation). The study also incorporates translational research including imaging and tissue biomarkers. (C) 2018 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology.

引用

页码：48 / 60

页数：13

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