% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Wark:300142,
      author       = {A. Wark and L. Hüfner and E. Meixner and J. Oelmann and L.
                      König and S. Höne and K. Lindel and J. Debus$^*$ and N.
                      Arians},
      title        = {{C}linical {I}mpact of {MRI}-{G}uided
                      {I}ntracavitary-{I}nterstitial {B}rachytherapy in the
                      {C}urative {M}anagement of {A}dvanced-{S}tage {C}ervical
                      {C}ancer.},
      journal      = {Current oncology},
      volume       = {32},
      number       = {3},
      issn         = {1198-0052},
      address      = {Toronto, Ontario},
      publisher    = {Multimed},
      reportid     = {DKFZ-2025-00633},
      pages        = {136},
      year         = {2025},
      abstract     = {This study investigates the clinical efficacy of MRI-based
                      adaptive brachytherapy (IGABT) using combined intracavitary
                      and interstitial techniques in the curative treatment of
                      patients with advanced cervical cancer (LACC). A
                      retrospective analysis was conducted on 149 LACC patients
                      treated at a single center. The therapeutic protocol
                      included intensity-modulated external beam radiotherapy
                      (IMRT) and IGABT. Dosimetric parameters were evaluated for
                      relevance for local control (LC), progression-free survival
                      (PFS), and overall survival (OS) using Kaplan-Meier
                      estimation, Cox regression, and log-rank test. Patients
                      predominantly presented with stage III/IV tumors $(81\%,$
                      FIGO 2018). The median high-risk clinical target volume
                      (hrCTV) was 34 cm3, with a median $D90\%$ dose of 88.9
                      GyEQD2. At 24 months, OS, PFS, and LC rates were $86\%,$
                      $57\%,$ and $81\%,$ respectively. FIGO stage, tumor volume,
                      and histology were significant predictors of PFS. Higher
                      total hrCTV doses were strongly correlated with improved LC
                      and PFS, emphasizing the importance of precise dosimetric
                      optimization in IGABT and confirming the critical role of
                      IGABT in achieving very good LC rates for LACC. The reported
                      LC rates are comparable to landmark studies, such as
                      INTERLACE and KEYNOTE-A18. This study validates the
                      effectiveness of MRI-guided IGABT in enhancing local tumor
                      control in advanced-stage cervical cancer while providing
                      insights into the prognostic implications of dosimetric
                      parameters such as hrCTV and point A. Future research should
                      address the persistent challenge of distant metastases by
                      exploring the integration of novel systemic treatment
                      options.},
      keywords     = {Humans / Female / Uterine Cervical Neoplasms: radiotherapy
                      / Brachytherapy: methods / Middle Aged / Adult / Magnetic
                      Resonance Imaging: methods / Aged / Retrospective Studies /
                      Aged, 80 and over / Neoplasm Staging / Radiotherapy,
                      Image-Guided: methods / MRI-guidance (Other) / advanced
                      cervical cancer (Other) / image-guided adaptive
                      brachytherapy (Other)},
      cin          = {E050 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)E050-20160331 / I:(DE-He78)HD01-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40136340},
      pmc          = {pmc:PMC11940836},
      doi          = {10.3390/curroncol32030136},
      url          = {https://inrepo02.dkfz.de/record/300142},
}