Long-term results of 1-week intravaginal high-dose-rate brachytherapy alone for endometrial cancer

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• 作者：Miren Gazta&#241 ; aga¹ ; ^{mgaztana@unav.es} ; Mauricio Cambeiro¹ ; Elena Villafranca² ; Meritxell Vila² ; Matí ; as Jurado³ ; Marta Moreno¹ ; Rafael Martí ; nez-Monge¹
• 关键词：Endometrial cancer ; Intravaginal brachytherapy ; High-dose rate ; Exclusive
• 刊名：Brachytherapy
• 出版年：2012
• 出版时间：March-April, 2012
• 年：2012
• 卷：11
• 期：2
• 页码：119-124
• 全文大小：96 K

文摘

Objective

To compare the biologic equivalence in terms of local control and toxicity of a short course of high-dose-rate intravaginal brachytherapy alone (IVBa) delivered over five consecutive days (25 Gy/5 Rx/5 days) to other more protracted classical schemes 21 Gy/3 Rx/14-28 days (Postoperative Radiation Therapy in Endometrial Carcinoma [PORTEC]-2/Memorial Sloan-Kettering Cancer Center).

Methods and Materials

From February 2001 to May 2008, 122 patients with International Federation of Gynecology and Obstetrics Stage IaG3-IIIaG2 endometrial adenocarcinoma were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by postoperative IVBa. Seventy-seven patients (63.1 % ) underwent surgical staging. Total IVBa dose was 25 Gy in five consecutive daily fractions prescribed at 0.5-cm depth.

Results

After a median followup of 4.1 years, the rates of Radiation Therapy Oncology Group Grades 1, 2, and ? complications were 12.9 % , 3.4 % , and 0.8 % , respectively. Five patients (4.1 % ) presented locoregional failures: two isolated nodal pelvic failures, one vaginal pelvic relapse (intra-abdominal lymph node metastases), one vaginal distant failure, and one combined locoregional and distant failure. The 8.5-year actuarial vaginal control rate was 97.5 % , and the pelvic control rate was 94.3 % . Six other patients developed distant metastases alone. The 8.5-year actuarial overall and disease-free survival rates were 90.3 % and 87.2 % , respectively. Univariate analysis revealed that?histologic grade, deep myometrial invasion, advanced age, and categorization as high intermediate-risk patient according to the PORTEC-2 and the Gynecologic Oncology Group (GOG)-99 stratifications were statistically significant prognostic factors. After multivariate analysis, histologic grade (p = 0.001) and high intermediate risk according to GOG-99 (p = 0.004) and PORTEC-2 (p = 0.001) remained significant.

Conclusions

The proposed scheme reproduces the excellent results obtained with more protracted schemes and has the added advantage of shortened overall treatment time.