A Prospective Evaluation of FDG PET Adapted IMRT/VMAT for Node Positive GYN Cancers Junzo Chino MD,...
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Transcript of A Prospective Evaluation of FDG PET Adapted IMRT/VMAT for Node Positive GYN Cancers Junzo Chino MD,...
A Prospective Evaluation of FDG PET Adapted
IMRT/VMAT for Node Positive GYN Cancers
Junzo Chino MD, Irina Vergalasova PhD, Jeff Nawrocki BS, and Oana Craciunescu PhD
Trial Design• Prospective Single Arm• Enrolled Cervical, Uterine, Vulvar Cancers
• This Poster Report Early results of Node Positive Patients
• PET-CT immediately prior to treatment• Definitive Treatment Planned
• 45-50Gy to elective volume• 55-70Gy to PET + Nodes
• Intratreatment PET-CT obtained at 30-36Gy• All Patients replanned
• Only Volumes changed, total dose was kept constant• Brachy used to boost residual central disease
Initial Results• 16 enrolled: 10 Cervix, 4 Uterine, 2 Vulvar• Interim PET Response: • 3 Minimal, 11 Partial, 2 Complete
• Doses to all OAR examined reduced with adapted plans• Bowel Dose was clinically significant
• Median D2cc 55.4 reduced to 52.6
• Women with PA nodal involvement had larger reductions in Dose• No associations with Response or Primary site
Conclusions
• Interim PET based Adaptive planning feasible and is associated with reduced dose to OAR.• Accrual Ongoing with attention to patterns of
failure and toxicity• Next generation protocol: Dose adaptation based
on interim response