Brachytherapy in vaginal cancer for organ preservation: Clinical outcome and safety from a single center experience.

Brachytherapy Dose-escalation Organ-sparing Vaginal cancer

Journal

Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304

Informations de publication

Date de publication:
13 Aug 2024
Historique:
received: 10 06 2024
revised: 27 07 2024
accepted: 29 07 2024
medline: 15 8 2024
pubmed: 15 8 2024
entrez: 14 8 2024
Statut: aheadofprint

Résumé

Interstitial and/or intracavitary brachytherapy is an integral part of the treatment of vaginal cancer Brachytherapy (BT) has shown to improve local control, overall survival (OS) and disease-free survival (DFS). The aim of our study was to analyze the efficacy and safety of brachytherapy in patients with vaginal cancer. Between 2000 and 2023, 27 patients with vaginal cancer in stage FIGO I-III were treated with brachytherapy with or without external beam radiotherapy (EBRT) and simultaneous chemotherapy. Brachytherapy has been performed either as PDR-brachytherapy alone with a median cumulative dose up to 62.5 Gy (EQD2 = 63.9 Gy) or with PDR-BT boost with median dose of 30.9 Gy (EQD2 = 30.4 Gy). HDR-BT was administered solely as boost with a median dose of 25.5 Gy (EQD2 = 47.8 Gy). The median dose of EBRT was 48.7 Gy and 49.4 Gy for primary and for pelvic lymph nodes. Median follow-up was 39 months (2-120). 5/27 patients developed local recurrences and the 5-year cumulative local recurrence rate for whole patient population was 18.5%. 5-year OS and DFS was 90% and 68%. 5-year DFS for Stage I-II was 72% and for Stage III 65% (p = 0.933). Grade 3 late side effects of brachytherapy were documented in 3/22 patients (13.6%), one patient experienced Grade 4 toxicity (4.5%). Brachytherapy with or without EBRT and concomitant chemotherapy for vaginal cancer is a safe and effective treatment option with excellent local control and overall survival and acceptable toxicity.

Sections du résumé

BACKGROUND BACKGROUND
Interstitial and/or intracavitary brachytherapy is an integral part of the treatment of vaginal cancer Brachytherapy (BT) has shown to improve local control, overall survival (OS) and disease-free survival (DFS). The aim of our study was to analyze the efficacy and safety of brachytherapy in patients with vaginal cancer.
MATERIALS AND METHODS METHODS
Between 2000 and 2023, 27 patients with vaginal cancer in stage FIGO I-III were treated with brachytherapy with or without external beam radiotherapy (EBRT) and simultaneous chemotherapy. Brachytherapy has been performed either as PDR-brachytherapy alone with a median cumulative dose up to 62.5 Gy (EQD2 = 63.9 Gy) or with PDR-BT boost with median dose of 30.9 Gy (EQD2 = 30.4 Gy). HDR-BT was administered solely as boost with a median dose of 25.5 Gy (EQD2 = 47.8 Gy). The median dose of EBRT was 48.7 Gy and 49.4 Gy for primary and for pelvic lymph nodes.
RESULTS RESULTS
Median follow-up was 39 months (2-120). 5/27 patients developed local recurrences and the 5-year cumulative local recurrence rate for whole patient population was 18.5%. 5-year OS and DFS was 90% and 68%. 5-year DFS for Stage I-II was 72% and for Stage III 65% (p = 0.933). Grade 3 late side effects of brachytherapy were documented in 3/22 patients (13.6%), one patient experienced Grade 4 toxicity (4.5%).
CONCLUSION CONCLUSIONS
Brachytherapy with or without EBRT and concomitant chemotherapy for vaginal cancer is a safe and effective treatment option with excellent local control and overall survival and acceptable toxicity.

Identifiants

pubmed: 39142090
pii: S0090-8258(24)01047-3
doi: 10.1016/j.ygyno.2024.07.683
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

35-41

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare no conflict of interest.

Auteurs

Ricarda Merten (R)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany. Electronic address: ricarda.merten@uk-erlangen.de.

Vratislav Strnad (V)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Andre Karius (A)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Michael Lotter (M)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Stephan Kreppner (S)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Claudia Schweizer (C)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Rainer Fietkau (R)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Philipp Schubert (P)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Classifications MeSH