Stereotactic body radiotherapy boost as an alternative to brachytherapy for cervical cancer: a scoping review
A partir d'une revue de la littérature (16 études), cette étude évalue l'efficacité et la sécurité d'une radiothérapie stéréotaxique de type "boost" chez des patientes atteintes d'un cancer du col de l'utérus et ne pouvant bénéficier d'une curiethérapie
Résumé en anglais
Purpose: This scoping review aims to evaluate the evidence for stereotactic body radiotherapy (SBRT) boost as a potential alternative for brachytherapy (BCT) in treating cervical cancer.
Material and Methods: A comprehensive literature search was conducted across multiple databases. Studies investigating SBRT boost in cervical cancer patients who were either contraindicated for or refused BCT were included. The review examined SBRT efficacy and safety.
Results: Sixteen studies were included, encompassing prospective (n=4) and retrospective cohort studies (n=8), as well as phase I and II trials (n=4). The most common SBRT boost dose was 25 Gray(Gy)/5 fractions (ranging from 18 - 40Gy/3 to 5 fractions). Local control rates at 1-year, 3-year, and 5-year ranged from 86% to 100%, 78% to 92%, and 81% to 92%, respectively. Overall survival (OS) rates at 1-year, 3-year, and 5-year rates ranged from 49% to 95%, 50% to 77%, and 50% to 69%, respectively. Two studies reported a pathological complete response rate of 93% and 94% three months after the SBRT boost. Most studies reported low rates of late grade 3 or higher genitourinary (0-14%) and gastrointestinal (0-26%) toxicities. The overall incidence of rectovaginal fistulas ranged from 0-13%.
Conclusion: This scoping review suggests SBRT boost as a promising alternative to selected cervical cancer patients who cannot receive BCT. The results indicate a high local control with acceptable toxicity profiles. However, further research is needed to define optimal SBRT boost parameters, identify patient selection criteria, and address knowledge gaps regarding long-term outcomes and cost-effectiveness.
