Comparison of intracavitary brachytherapy and stereotactic body radiotherapy dose distribution for cervical cancer: In regard to Cengiz etal.

摘要

To the Editor: We have read with interest the comparison by Dr Cengiz et al. (1). In the last decade, technological advancements in tumor imaging, treatment planning, and various forms of high-precision delivery techniques have been dramatic, definitely leading to favorable toxicity profiles (2). Gynecologic brachytherapy has also embraced these new tools for three-dimensional Image-guided adaptive implants. The CT imaging for cervical cancer brachytherapy patients lacks soft tissue definition that has been overcome by MRI (3), and point A-based prescriptions are discouraged (4). The present study used CT-based planning where the current standard is MRI-guided adaptive brachytherapy. The Groupe Europeen de Curietherapie and the European Society for Radiotherapy and Oncology have spearheaded the research in this area with consistent reporting of excellent improved clinical outcomes (5). As such, the volumes advocated, namely intermediate- and high-risk clinical target volumes, cannot be reliably drawr on CT scans without the aid of MRI. Without appropriate target delineation, comparison of plans may be misleading.