TY - JOUR
T1 - The EMBRACE II study
T2 - The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies
AU - Pötter, Richard
AU - Tanderup, Kari
AU - the EMBRACE Collaborative Group
AU - Kirisits, Christian
AU - de Leeuw, Astrid
AU - Kirchheiner, Kathrin
AU - Nout, Remi
AU - Tan, Li Tee
AU - Haie-Meder, Christine
AU - Mahantshetty, Umesh
AU - Segedin, Barbara
AU - Hoskin, Peter
AU - Bruheim, Kjersti
AU - Rai, Bhavana
AU - Huang, Fleur
AU - Van Limbergen, Erik
AU - Schmid, Max
AU - Nesvacil, Nicole
AU - Sturdza, Alina
AU - Fokdal, Lars
AU - Jensen, Nina Boje Kibsgaard
AU - Georg, Dietmar
AU - Assenholt, Marianne
AU - Seppenwoolde, Yvette
AU - Nomden, Christel
AU - Fortin, Israel
AU - Chopra, Supriya
AU - van der Heide, Uulke
AU - Rumpold, Tamara
AU - Lindegaard, Jacob Christian
AU - Jürgenliemk-Schulz, Ina
N1 - The EMBRACE I and II studies have been supported by Elekta and Varian Medical Systems.
Publisher Copyright: © 2018 The Authors
PY - 2018/2
Y1 - 2018/2
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85044132028&partnerID=8YFLogxK
U2 - 10.1016/j.ctro.2018.01.001
DO - 10.1016/j.ctro.2018.01.001
M3 - Review article
AN - SCOPUS:85044132028
VL - 9
SP - 48
EP - 60
JO - Clinical and Translational Radiation Oncology
JF - Clinical and Translational Radiation Oncology
SN - 2405-6308
ER -
