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Radiother Oncol. 2010 Jan;94(1):53-9. doi: 10.1016/j.radonc.2009.12.004. Epub 2010 Jan 14.

Stereotactic body radiotherapy for local boost irradiation in unfavourable locally recurrent gynaecological cancer.

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1
Department of Radiation Oncology, Julius-Maximilians University, Wuerzburg, Germany. guckenberger_m@klinik.uni-wuerzburg.de

Abstract

PURPOSE:

To evaluate outcome of radiotherapy for locally recurrent cervical and endometrial cancer.

MATERIALS AND METHODS:

Nineteen patients were treated for a locally recurrent cervical (n=12) or endometrial (n=7) cancer median 26 months after initial surgery (n=18) or radiotherapy (n=1). The whole pelvis was irradiated with 50Gy conventionally fractionated radiotherapy (n=16). Because of large size of the recurrent cancer (median 4.5 cm) and peripheral location (n=12), stereotactic body radiotherapy (SBRT; median 3 fractions of 5Gy to 65%) was used for local dose escalation instead of (n=16) or combined with (n=3) vaginal brachytherapy.

RESULTS:

After median follow-up of 22 months, 3-year overall survival was 34% with systemic progression the leading cause of death (7/10). Median time to systemic progression was 16 months. Three local recurrences resulted in a local control rate of 81% at 3 years. No correlation between survival, systemic or local control and any patient or treatment characteristic was observed. The rate of late toxicity>grade II was 25% at 3 years: two patients developed a grade IV intestino-vaginal fistula and one patient suffered from a grade IV small bowel ileus.

CONCLUSION:

Image-guided SBRT for local dose escalation resulted in high rates of local control but was associated with significant late toxicity.

PMID:
20079550
DOI:
10.1016/j.radonc.2009.12.004
[Indexed for MEDLINE]
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