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Clin Transl Oncol. 2016 Sep;18(9):925-30. doi: 10.1007/s12094-015-1463-z. Epub 2015 Dec 11.

Vaginal-cuff control and toxicity results of a daily HDR brachytherapy schedule in endometrial cancer patients.

Author information

1
Radiation Oncology Department, ICMHO, Functional Gynecologic Cancer Unit, Hospital Clinic Universitari, C/Villarroel no. 170, 08036, Barcelona, Spain. ivanriosh@gmail.com.
2
Radiation Oncology Department, Cancer Institute, Centro Medico Imbanaco, Cali, Colombia. ivanriosh@gmail.com.
3
Radiation Oncology Department, ICMHO, Functional Gynecologic Cancer Unit, Hospital Clinic Universitari, C/Villarroel no. 170, 08036, Barcelona, Spain.
4
Public and Health Department, Medicine Faculty, Universitat de Barcelona, Barcelona, Spain.
5
Radiation Oncology Department, Hospital General de Albacete, Albacete, Spain.
6
Gynecological Surgery, Functional Gynecologic Cancer Unit, Hospital Clinic I Universitari, Barcelona, Spain.
7
Radiation Oncology Department, Hospital Sant Joan de Reus, Tarragona, Spain.

Abstract

PURPOSE:

To analyze the vaginal-cuff local control (VCC) and toxicity in postoperative endometrial carcinoma patients (EC) underwent high-dose-rate brachytherapy (HDR-BT) administered daily.

MATERIALS AND METHODS:

154 consecutive patients received postoperative HDR-BT for EC from January 2007 to September 2011. FIGO-staging I-IIIC2 patients were divided into two groups according to risk classification: Group 1 (94/154) included high-risk or advanced disease patients and Group 2 (60/154) included intermediate-risk EC patients. Group 1 underwent external beam irradiation (EBI) plus HDR-BT (2 fractions of 5 Gy) and Group 2 underwent HDR-BT alone (4 fractions of 5 Gy). Toxicity evaluation was done with RTOG scores for bladder and rectum, and the objective criteria of LENT-SOMA for vagina.

RESULTS:

With a median follow-up of 46.7 months (36.6-61 months) only two patients developed vaginal-cuff recurrence in Group 1 (2.1 %) and none in group 2 (0 %). Early toxicity in Group 1 appeared 5.3 % in rectum, 7.5 % in bladder (G1-G2) and 2.1 % in vagina (G1); late toxicity was present in 7.3 % in rectum (all G1-G2 but 1 G3) and in 27.7 % in vagina (all G1-G2 but one G4). In Group 2, 6.7 % developed acute G1-G2 bladder and 6.6 % acute vaginal (G1-G2) toxicity. No late rectal or bladder toxicity was observed; 21.7 % of G1-G2 presented late problems in vagina.

CONCLUSIONS:

The present HDR-BT schedule of 2 fractions of 5 Gy after EBI and 4 fractions of 5 Gy administered daily showed excellent results in terms of VCC and toxicity.

KEYWORDS:

Brachytherapy schedules; Endometrial cancer; Endometrial cancer adjuvant treatment; Gynecologic brachytherapy

PMID:
26661111
DOI:
10.1007/s12094-015-1463-z
[Indexed for MEDLINE]

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