Clinical and Translational Radiation Oncology· 2018Q1
The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies
- 938citations
- Q1SCImago
- 2018year
Short summary
The EMBRACE II study benchmarks state-of-the-art image-guided adaptive brachytherapy (IGABT) for locally advanced cervical cancer, aiming for superior local, nodal, and systemic control while minimizing morbidity.
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Key points
- EMBRACE II is a multicenter study benchmarking advanced IGABT techniques for locally advanced cervical cancer.
- The study validates an evidence-based prospective dose and volume prescription protocol.
- It aims to achieve high levels of local, nodal, and systemic control while limiting treatment-related morbidity.
- Advanced EBRT (IMRT/IGRT) and brachytherapy (IC/IS) techniques are central to the study's validation.
- Translational research, including imaging and tissue biomarkers, is incorporated.
AI-generated from the title and abstract; the full text is not read.
Abstract
The publication of the GEC-ESTRO recommendations one decade ago was a significant step forward for reaching international consensus on adaptive target definition and dose reporting in image guided adaptive brachytherapy (IGABT) in locally advanced cervical cancer. Since then, IGABT has been spreading, particularly in Europe, North America and Asia, and the guidelines have proved their broad acceptance and applicability in clinical practice. However, a unified approach to volume contouring and reporting does not imply a unified administration of treatment, and currently both external beam radiotherapy (EBRT) and IGABT are delivered using a large variety of techniques and prescription/fractionation schedules. With IGABT, local control is excellent in limited and well-responding tumours. The major challenges are currently loco-regional control in advanced tumours, treatment-related morbidity, and distant metastatic disease. Emerging evidence from the RetroEMBRACE and EMBRACE I studies has demonstrated that clinical outcome is related to dose prescription and technique. The next logical step is to demonstrate excellent clinical outcome with the most advanced EBRT and brachytherapy techniques based on an evidence-based prospective dose and volume prescription protocol. The EMBRACE II study is an interventional and observational multicentre study which aims to benchmark a high level of local, nodal and systemic control while limiting morbidity, using state of the art treatment including an advanced target volume selection and contouring protocol for EBRT and brachytherapy, a multi-parametric brachytherapy dose prescription protocol (clinical validation of dose constraints), and use of advanced EBRT (IMRT and IGRT) and brachytherapy (IC/IS) techniques (clinical validation). The study also incorporates translational research including imaging and tissue biomarkers.
The authors' abstract, as published at the source. Clinical and Translational Radiation Oncology, 2018 · DOI ↗
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Field: Obstetrics and Gynecology
Obstetrics and GynecologyMedicine