Do vaginal recurrence rates differ among adjuvant vaginal brachytherapy regimens in early-stage endometrial cancer?

Autor:	Ager BJ; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Francis SR; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Do OA; Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Huang YJ; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Soisson AP; Department of Obstetrics and Gynecology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Dodson MK; Department of Obstetrics and Gynecology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Werner TL; Department of Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT., Sause WT; Department of Radiation Oncology, Intermountain Medical Group, Intermountain Healthcare, Salt Lake City, UT., Grant JD; Department of Radiation Oncology, Intermountain Medical Group, Intermountain Healthcare, Salt Lake City, UT., Gaffney DK; Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT. Electronic address: David.Gaffney@hci.utah.edu.
Jazyk:	angličtina
Zdroj:	Brachytherapy [Brachytherapy] 2019 Jul - Aug; Vol. 18 (4), pp. 453-461. Date of Electronic Publication: 2019 Apr 17.
DOI:	10.1016/j.brachy.2019.03.001
Abstrakt:	Purpose: We sought to retrospectively examine clinical outcomes for three adjuvant vaginal high-dose-rate (HDR) brachytherapy regimens after hysterectomy for early-stage endometrial cancer. Methods: Included were women of all ages from two independent hospital systems diagnosed with Stage I-II endometrial cancer of any grade between 2000 and 2016 who underwent hysterectomy followed by adjuvant vaginal cylinder HDR brachytherapy with either 7.0 Gy × 3 fractions prescribed to 0.5 cm vaginal depth, 6.5 Gy × 3 fractions prescribed to 0.5 cm vaginal depth, or 6.0 Gy × 5 fractions prescribed to the vaginal surface. Outcomes included vaginal recurrence (VR), pelvic recurrence, distant recurrence, locoregional recurrence, recurrence-free survival, and overall survival. Results: Of the 348 women, 45 (13%) received 7.0 Gy × 3 fractions, 259 (74%) received 6.5 Gy × 3 fractions, and 44 (13%) received 6.0 Gy × 5 fractions. Women receiving 5-fraction brachytherapy were more likely to be younger with a higher performance status. At a median follow-up of 4.5 years, VR rates were 2.2%, 0.8%, and 4.5%, respectively. Multivariate analysis revealed no significant differences in the risks for VR among brachytherapy regimens. Risks for VR, pelvic recurrence, distant recurrence, locoregional recurrence, recurrence-free survival, and overall survival did not differ between propensity score-matched five- and 3-fraction brachytherapy cohorts. Conclusions: VR rates after hysterectomy and adjuvant vaginal brachytherapy for early-stage endometrial cancer were low and not significantly different by HDR dose fractionation. (Copyright © 2019 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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