Early clinical outcomes of hybrid brachytherapy for locally advanced cervical cancer: making adverse situations in a favorable scenario.

image-guided adaptive brachytherapy interstitial brachytherapy local control locally advanced cervical cancer vaginal morbidity

Journal

Journal of contemporary brachytherapy
ISSN: 1689-832X
Titre abrégé: J Contemp Brachytherapy
Pays: Poland
ID NLM: 101506276

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 04 05 2022
accepted: 05 08 2022
entrez: 6 10 2022
pubmed: 7 10 2022
medline: 7 10 2022
Statut: ppublish

Résumé

To investigate the feasibility and early clinical outcomes of combined intra-cavitary (IC) and interstitial (IS) image-guided adaptive brachytherapy (IGABT) as curative and definitive treatment of patients treated with chemoradiotherapy (CCRT) for locally advanced cervical cancer (LACC). Data from medical records of all consecutive patients with histologically proven cervical cancer (FIGO 2018 stage IB-IV), treated by brachytherapy after CCRT at our institution between 2017 and 2020 were reviewed. One hundred and forty-two patients with LACC FIGO 2018 stages (IB: 20.4%, II: 31.7%, III: 45.8%, IV: 2.1%) underwent brachytherapy at our institution, out of which 53.5% underwent combined brachytherapy technique (IC/IS). Median number of implanted catheters was 3 (range, 1-6 catheters). None of the 142 patients required invasive hemorrhage management. With a median follow-up of 21.6 (95% CI [confidence interval]: 19.1-23.5%) months, local relapse was observed in nine patients (6.3%), with four showing persistent and progressive disease. The estimated 2-year local and pelvic relapse-free survival were 92% (95% CI: 84-96%) and 90% (95% CI: 83-94%), respectively. The estimated 2-year disease-free survival for the entire population was 80% (95% CI: 71-87%). The 2-year overall survival (OS) rate for the entire population was 92% (95% CI: 84-96%). Acute toxicity G3 was reported in two (1.4%) patients. High-grade late toxicity (grade 3) was reported in 9 (6.3%) patients. Combined IC/IS brachytherapy for LACC allows for recommended doses to achieve local control even in large tumors after CCRT improving target volume coverage, with low rates of acute morbidity. Hybrid brachytherapy technique (IC/IS) is essential to have a favorable scenario at the time of brachytherapy to correctly treat locally advanced cervical cancer patients.

Identifiants

pubmed: 36199941
doi: 10.5114/jcb.2022.118831
pii: 47660
pmc: PMC9528831
doi:

Types de publication

Journal Article

Langues

eng

Pagination

321-331

Informations de copyright

Copyright © 2022 Termedia.

Déclaration de conflit d'intérêts

The authors report no conflict of interest.

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Auteurs

Leonel Varela Cagetti (LV)

Department of Radiation Oncology, Institut Paoli-Calmettes, Marseille, France.

Christophe Zemmour (C)

Department of Clinical Research and Investigation, Biostatistics and Methodology Unit, Institut Paoli-Calmettes, Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.

Eric Lambaudie (E)

Department of Surgical Oncology, Institut Paoli-Calmettes, Aix-Marseille Univ, CNRS, INSERM, CRCM, Marseille, France.

Magalie Provansal (M)

Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.

Renaud Sabatier (R)

Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France.
Département d'Oncologie Moléculaire, "Equipe labellisée Ligue Contre le Cancer", Centre de Recherche en Cancérologie de Marseille (CRCM), Institut Paoli-Calmettes, INSERM UMR1068, CNRS UMR725, Marseille, France.

Laura Sabiani (L)

Institut Paoli Calmettes, Oncology Surgery 2, Institut Paoli-Calmettes, Marseille, France.

Guillaume Blache (G)

Institut Paoli Calmettes, Oncology Surgery 2, Institut Paoli-Calmettes, Marseille, France.

Camille Jauffret (C)

Institut Paoli Calmettes, Oncology Surgery 2, Institut Paoli-Calmettes, Marseille, France.

Marjorie Ferré (M)

Department of Medical Physics, Institut Paoli-Calmettes, Marseille, France.

Agnès Tallet (A)

Department of Radiation Oncology, Institut Paoli-Calmettes, Marseille, France.

Laurence Gonzague (L)

Department of Radiation Oncology, Institut Paoli-Calmettes, Marseille, France.

Classifications MeSH