Management of Bartholin¡¯s gland carcinoma using high-dose-rate interstitial brachytherapy boost

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• 作者：Isabelle Thibault ; Marie-Claude Lavall¨¦e ; Sylviane Aubin ; Suneil Jain ; Nathalie Laflamme ; ¨¦ric Vigneault
• 关键词：Bartholin&rsquo ; s gland carcinoma ; Interstitial brachytherapy ; High-dose rate ; IPSA
• 刊名：Brachytherapy
• 出版年：2013
• 出版时间：September-October, 2013
• 年：2013
• 卷：12
• 期：5
• 页码：500-507
• 全文大小：587 K

文摘

Purpose

To describe the patterns of use, clinical outcomes, and dose-volume histogram parameters of high-dose-rate interstitial brachytherapy (HDR-ISBT) in the management of Bartholin¡¯s gland cancer.

Methods and Materials

Five patients with Stage II-III Bartholin¡®s gland carcinoma treated with CT-based HDR-ISBT boost were reviewed. Plans were generated using an inverse planning simulated annealing algorithm. Dose-volume histogram parameters were assessed. The total doses of HDR-ISBT and EBRT were converted to total equivalent dose in 2 Gy (EQD₂).

Results

All 5 patients received HDR-ISBT as a boost (median dose, 30 Gy) after EBRT (median dose, 45 Gy). Three patients received postoperative irradiation for gross residual tumor or positive surgical margins and 2 patients were treated by primary chemoradiotherapy. The median V₁₀₀, D₉₀, and D₁₀₀ for the CTV were 98.3 % , 89 Gy₁₀, and 64 Gy₁₀ (EQD₂), respectively. A complete response was observed in all patients. No local recurrence occurred. All patients remain alive and free of disease (median followup, 78 months; range, 8-93). Severe vaginal toxicities were observed, including vaginal necrosis that resolved with hyperbaric oxygen therapy.

Conclusions

HDR-ISBT boost after EBRT offers excellent long-term local control in patients with Bartholin¡¯s gland carcinoma. HDR-ISBT should be considered for positive surgical margins or residual tumor after surgery and for locally advanced malignancies treated by primary chemoradiotherapy.