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

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• 作者：Matthias Guckenberger ; Johanna Bachmann ; Joern Wulf ; Gerd Mueller ; Thomas Krieger ; Kurt Baier ; Anne Richter ; Juergen Wilbert ; Michael Flentje
• 关键词：Stereotactic body radiotherapy ; Local recurrence ; Cervical cancer ; Endometrial cancer ; Image-guided radiotherapy
• 刊名：Radiotherapy and Oncology
• 出版年：2010
• 出版时间：January 2010
• 年：2010
• 卷：94
• 期：1
• 页码：53-59
• 全文大小：446 K

文摘

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 50 Gy 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 5 Gy 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.