Dose Optimization in 3D Pulsed Dose Rate Brachytherapy for Patients With Locally Advanced Cervical Cancer

A Prospective Open Label Phase II Study to Optimize the Dose in 3D Pulsed Dose Rate Brachytherapy in Patients With Locally Advanced Cervical Cancer

This prospective phase II trial study aims to optimize the increase in dose to the target volume at high risk (85 to 90 Gy over 90% of its volume) and the intermediate target volume (60 Gy to 90 % of its volume) in 3D Pulsed Dose Rate Brachytherapy in treating patients with locally advanced cervical cancer.

• The causes of treatment failure and death in cervical cancer are still often linked to a local cancer progression
• The importance of local control for healing, than the cervix situation in the center of pelvis between bladder and rectum which are sensitive organs to irradiation justify the use of utero-vaginal brachytherapy
• This open label, multicenter, phase II study evaluates the benefit of increasing in dose to the target volume at high risk and the intermediate target volume in 3D Pulsed Dose Rate Brachytherapy in treating patients with locally advanced cervical cancer.
• Local control and tolerance are evaluated

Inclusion Criteria:

• primitive cervical cancer
• adenocarcinoma histologically advanced
• IB2, II and III stage
• curative treatment
• indication of utero-vaginal brachytherapy with external radiotherapy
• non-metastatic tumor and life expectancy > 6 months
• patient informed and follow possible
• performance status ≤ 2
• unplanned surgery
• age ≥ 18 years old
• ability to provide written informed consent before the start of any study specific procedures

Exclusion Criteria:

• primitive endometrial cancer
• other diseases
• carcinoma in situ and stages ≤ B
• distant metastases
• history of pelvic irradiation or a first pelvic cancer
• contraindication to MRI
• history of subtotal or total hysterectomy
• pregnant or breast feeding females
• inability to support low dose rate continuous brachytherapy or pulsed flow
• person in emergencies
• person unable to give personally consent
• patient participating in another clinical research except in case of local recurrence or observational research