Format

Send to

Choose Destination
J Gynecol Oncol. 2017 Nov;28(6):e84. doi: 10.3802/jgo.2017.28.e84.

Impact of vaginal cylinder diameter on outcomes following brachytherapy for early stage endometrial cancer.

Author information

1
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA.
2
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
3
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA. shari.damast@yale.edu.

Abstract

OBJECTIVE:

To examine the outcomes (tolerability, toxicity, and recurrence) of vaginal brachytherapy (VBT) among endometrial cancer (EC) patients treated with small cylinder size.

METHODS:

Patients with EC who received adjuvant VBT between September 2011 and December 2015 were reviewed. Patients were fitted with the largest vaginal cylinder they could comfortably accommodate, from 2.0-3.0 cm diameter. Small cylinders were defined as size 2.3 cm or less. Patient, tumor, or treatment characteristics were correlated with need for small cylinders. Treatment tolerability, measures of gastrointestinal (GI), genitourinary (GU), and vaginal toxicity, and rates of recurrence were analyzed.

RESULTS:

Three hundred four patients were included. Small cylinders were used in 51 patients (17%). Normal body mass index (BMI; p<0.001), nulligravidity (p<0.001), and shorter vaginal length (p<0.001) were associated with small cylinder size. There was no acute or late grade 3 toxicity. Rates of acute (grade 1-2) GI, GU, or vaginal symptoms were low (10%, 11%, and 19%, respectively). Small cylinder size was associated with increased likelihood of reporting acute GI (p<0.05) but not GU or vaginal symptoms. Small cylinder size was associated with higher risk of grade 1-2 vaginal stenosis (odds ratio [OR]=4.7; 95% confidence interval [CI]=1.5-14.7; p=0.007). There was no association between cylinder size and recurrence rate (p=0.55).

CONCLUSION:

VBT is generally very well tolerated, however, patients fitted with smaller cylinders (commonly nulligravid and low BMI) may have increased side effects. Further study to improve the dosimetry of VBT for patients requiring small cylinders may be worthwhile.

KEYWORDS:

Endometrial Cancer; Radiation; Toxicity; Vaginal Brachytherapy; Vaginal Stenosis

PMID:
29027402
PMCID:
PMC5641534
DOI:
10.3802/jgo.2017.28.e84
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology Icon for PubMed Central
Loading ...
Support Center