Feasibility of Pet-scan at Day 1 of Brachytherapy for Patients With Cervical Cancer

Feasibility of PET-scan Carried Out at Day 1 of Brachytherapy for Patients With Locally Advanced Cervical Cancer Treated Initially by Concomitant Radio-chemotherapy

Interventional, exploratory, prospective and monocentric study which aim to study the feasibility of brachytherapy using a PET-scan

The study will proceed as follow:

• Initial check-up before the brachytherapy, including a clinical exam, collect of disease history and other informations that can be required for a good execution of the trial, and a usual patient care (chemotherapy with concomitant radiotherapy, biopsy, RMI, PET-scan and paraaortic lymphadenectomy).
• additional PET-scan exam at day 1 of the brachytherapy (with collect of informations on toxicity, clinical morphology data and biomorphological data of RMI and PET-scan, and dosimetric study of the brachytherapy)
• 4 months after the brachytherapy, additional PET-scan monitoring metabolic volumes and standardized metabolic fixation parameters

Inclusion Criteria:

• Patient suffering from a cervical cancer:
• squamous-cell carcinoma or adenocarcinoma histologically proven
• classified from FIGO 2009 IB2 to IVA stage
• Age ≥ 18 years old
• Examination by PET-scan and pelvic RMI realized at diagnosis
• Examination by negative PET-scan remotely closed and at lymph node level
• Surgical lymphadenectomy negative at paraaortic level
• Treatment by external radiotherapy (doses between 45 Gy and 50.4 Gy in 1.8 Gy/fractions) and concomitant chemotherapy (at least 4 cures per weeks using platinum salt) done
• Scheduled curative treatment by brachytherapy driven by RMI
• Affiliation to the National Social Security System
• With informed and signed consent before any procedure specific to the study

Exclusion Criteria:

• Performance status of WHO score > 2
• Other histology than squamous cell carcinoma or adenocarcinoma
• Metastatic patient or paraaortic node positive
• Adjuvant radiochemotherapy after the first surgery
• Dementia or psychiatric history
• Kidney failure
• Diabet
• Chronic inflammatory bowel disease
• Pelvic and/or vesicoureteral surgery history
• Pelvic irradiation history
• Other active neoplasia or < 5 years old, except for basocellular carcinoma that can be locally treated
• Contraindication to one of the following procedure : RMI, PET-scan, general anesthesia
• Radiosensitive disease (Fragile X syndrome, Huntington's chorea, Xeroderma Pigmentosum, connective tissue disease) or signs of radiosensitivity.
• Treatment with palliative intent
• Pregnant or breastfeeding women
• Patient Under guardianship or tutorship