High-dose-rate brachytherapy boost for locally advanced cervical cancer: Oncological outcome and toxicity analysis of 4 fractionation schemes.

Autor: le Guyader M; Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, 33 avenue Valombrose, 06189 Nice Cedex 2, Nice, France., Lam Cham Kee D; Department of Radiation Oncology, Pôle Santé République, Clermont-Ferrand, France., Thamphya B; Department of Statistics, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice, France., Schiappa R; Department of Statistics, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice, France., Gautier M; Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, 33 avenue Valombrose, 06189 Nice Cedex 2, Nice, France., Chand-Fouche ME; Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, 33 avenue Valombrose, 06189 Nice Cedex 2, Nice, France., Hannoun-Levi JM; Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, 33 avenue Valombrose, 06189 Nice Cedex 2, Nice, France.
Jazyk: angličtina
Zdroj: Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2021 Nov 06; Vol. 32, pp. 15-23. Date of Electronic Publication: 2021 Nov 06 (Print Publication: 2022).
DOI: 10.1016/j.ctro.2021.10.005
Abstrakt: Purpose: Brachytherapy (BT) boost after radio-chemotherapy (RCT) is a standard of care in the management of locally advanced cervical cancer (LACC). As there is no consensus on high-dose-rate (HDR) BT fractionation schemes, our aim was to report the oncological outcome and toxicity profile of four different schemes using twice-a-day (BID) HDR-BT.
Patients and Methods: This was an observational, retrospective, single institution study for patients with LACC receiving a HDR-BT boost. The latter was performed with a single implant and single imaging done on day 1. The different fractionation schemes were: 7 Gy + 4x3.5 Gy (group 1); 7 Gy + 4x4.5 Gy (group 2); 3x7Gy (group 3) and 3x8Gy (group 4). Local (LFS), nodal (NFS) and metastatic (MFS) recurrence-free survival as well as progression-free survival (PFS) and overall survival (OS) were analyzed. Acute (≤6 months) and late toxicities (>6 months) were reported.
Results: From 2007 to 2018, 191 patients were included. Median follow-up was 57 months [45-132] and median EQD2 10 D 90 CTV HR was 84, 82 and 90 Gy for groups 2, 3 and 4 respectively (dosimetric data missing for group 1). The 5-year LFS, NFS, MFS, PFS and OS were 85% [81-90], 83% [79-86], 70% [67-73], 61% [57-64] and 75% [69-78] respectively, with no significant difference between the groups. EQD2 10 D 90 CTV HR  < 85 Gy was a prognostic factor for local recurrence in univariate analysis (p = 0.045). The rates of acute/late grade ≥ 2 urinary, digestive and gynecological toxicities were 9%/15%, 3%/15% and 9%/25% respectively.
Conclusion: Bi-fractionated HDR-BT boost seems feasible with good oncological outcome and slightly more toxicity after dose escalation.
Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2021 The Author(s).)
Databáze: MEDLINE
Externí odkaz: