Toxicity and Efficacy After Adjuvant Vaginal Brachytherapy Using 30 Gy in 6 Fractions for Stages I and II Endometrial Cancer.

Autor: Arden JD; Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan., Dokter J; Oakland University William Beaumont School of Medicine, Rochester, Michigan., Almahariq MF; Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan., Marvin K; Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan., Nandalur SR; Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan., Al-Wahab Z; Department of Gynecologic Oncology, Beaumont Health System, Royal Oak, Michigan., Gadzinski J; Department of Gynecologic Oncology, Beaumont Health System, Royal Oak, Michigan., Rosen B; Department of Gynecologic Oncology, Beaumont Health System, Royal Oak, Michigan., Jawad MS; Department of Radiation Oncology, Beaumont Health System, Royal Oak, Michigan.
Jazyk: angličtina
Zdroj: Advances in radiation oncology [Adv Radiat Oncol] 2021 Aug 12; Vol. 6 (6), pp. 100773. Date of Electronic Publication: 2021 Aug 12 (Print Publication: 2021).
DOI: 10.1016/j.adro.2021.100773
Abstrakt: Purpose: This study aimed to evaluate outcomes and toxicity in patients with endometrial cancer per our institutional adjuvant vaginal cuff brachytherapy (VBT) fractionation scheme.
Methods and Materials: We identified women with International Federation of Gynecology and Oncology stages I and II endometrial cancer who underwent surgical staging and adjuvant high-dose-rate VBT without external beam radiation. All patients received 30 Gy in 6 fractions to the upper one-third of the vagina, prescribed to a depth of 5 mm and delivered twice weekly. Toxicities were prospectively elicited at each follow up, and rates of recurrence and survival were retrospectively assessed.
Results: We identified 247 eligible patients treated between 1992 and 2018 with a median follow up of 5.8 years (range, 0.1-24.7 years). Most patients had stage I disease (52% stage IA; 37% stage IB), and 11% of patients were stage II. Deep myometrial invasion was predictive of local recurrence ( P  = .002). The 5-year rates of local recurrence, regional recurrence, and distant metastases were 5%, 5%, and 7%, respectively. Five-year overall and disease-free survival were 91% and 83%, respectively. The most common grade 1 toxicities were acute fatigue (11% crude rate), urinary frequency (11%), chronic (>6 months) urinary frequency (13%), urinary incontinence (13%), and vaginal stenosis (21%). There were few grade 2 toxicities (all <5%) and no grade 3 to 5 toxicities.
Conclusions: The adjuvant VBT fractionation scheme of 30 Gy in 6 fractions results in low rates of toxicity, with no grade ≥3 adverse events, and local control rates comparable with those from other published series using different fractionation schemes.
(© 2021 The Authors.)
Databáze: MEDLINE
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