Surface guided radiation therapy (SGRT) is a non-radiation, non-invasive technology that provides continuous postural monitoring of patients during radiotherapy. Using advanced 3D optical surface localization and tracking technology, SGRT quickly captures the surface contour information of patients through optical means to generate high-precision 3D surface contours, enabling real-time monitoring of patients during radiotherapy to ensure its accuracy. This image-guided technology has been widely applied in radiotherapy for tumors in different parts of the body, such as breast, intracranial, head and neck, and limbs. SGRT can reduce initial setup errors and provide real-time monitoring during treatment, or be combined with respiratory gating and deep inspiration breath-hold techniques. SGRT can also reduce radiation dose by reducing the use of CBCT, improve patient comfort with the use of immobilization devices, and enhance clinical speed, efficiency, and safety. This review aims to provide an overview of the commonly used technology and clinical applications of SGRT, and discuss its current limitations and future prospects.
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Original Article
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To investigate the clinical outcomes and recurrence patterns of high-intermediate-risk (HIR)- and high-risk (HR) early-stage endometrial cancer (EC) treated with postoperative intracavitary brachytherapy alone.
We included 152 patients with International Federation of Gynecology and Obstetrics (FIGO) stage I-II endometrial cancer with HIR and HR factors who received vaginal brachytherapy alone after surgery in our center between April 2008 and December 2017. The irradiation area was the top and upper halves of the vagina. The reference point was defined as 0.5 cm below the vaginal mucosa. The radiation dose was 25–30 Gy 5–6 times. The Kaplan–Meier method was used to calculate the survival rate; differences were assessed using the log-rank test, and univariate and multivariate prognostic analyses were performed using the Cox regression model.
The median follow-up was 49.2 months (range 3–132 months). The 5-year overall survival (OS), disease-free survival (DFS), locoregional failure-free survival time (LRFS), and distant metastasis-free survival (DMFS) rates were 93.2%, 83.4%, 87.9%, and 86.6%, respectively. Treatment failure occurred in 18 patients, locoregional recurrence in 11, and distant metastasis in 14 (four with locoregional recurrence). Distant metastasis is the main recurrence pattern in patients at HIR and HR. Univariate and multivariate analyses revealed that age was an independent prognostic factor for OS, DFS, DMFS, and LRFS.
The main recurrence pattern after adjuvant vaginal brachytherapy alone was distant metastasis in patients with HIR and HR early-stage EC. Age at onset was an independent prognostic factor for survival. Vaginal brachytherapy alone is an acceptable treatment option for patients with HIR and HR early-stage endometrial cancer.
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