Phase II trial of image-based high-dose-rate interstitial brachytherapy for previously irradiated gynecologic cancer
| Autor: | E. Villafranca, Matías Jurado, Luis Isaac Ramos, Mauricio Cambeiro, Alicia Olarte, Rafael Martínez-Monge, Natividad Bascón, Maria E. Rodriguez-Ruiz |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Genital Neoplasms Female medicine.medical_treatment Brachytherapy Salvage treatment Urology Planning target volume Disease-Free Survival Internal medicine Gynecologic cancer medicine Humans Radiology Nuclear Medicine and imaging Aged Salvage Therapy business.industry Disease progression Interstitial brachytherapy Radiotherapy Dosage Middle Aged Disease Progression Female Neoplasm Recurrence Local Dose rate business Image based |
| Zdroj: | Brachytherapy. 13:219-224 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2014.01.008 |
| Popis: | Purpose To report the disease-free Grade ≥3 complication-free survival of a Phase II protocol of reirradiation with high-dose-rate (HDR) interstitial brachytherapy (ITB) in previously irradiated gynecologic cancer. Methods and Materials Fifteen patients with previously irradiated cervical (n = 6), endometrial (n = 6), and vulvovaginal tumors (n = 3) were treated with HDR-ITB alone to a median dose of 38 Gy in 8 b.i.d. fractions over 4 consecutive days. Prior treatments included surgery (n = 12; 80%), external irradiation (n = 15; 100%), and brachytherapy (n = 9; 60%). Average clinical target volume Size was 60.9 cc (range, 14.8–165.3 cc), and median time to reirradiation was 3.9 years (range, 0.4–22.7 years). Results With a median followup of 2.8 years (range, 1.2–9.2 years), 3 patients (20.0%) developed Grade ≥3 toxicity consisting of Grade 3 intestinal obstruction (n = 1), Grade 4 rectovesical fistula (n = 1), and Grade 5 intestinal obstruction (n = 1). Six patients remain alive and without evidence of disease at last followup. Two patients are alive with disease progression, and 7 patients have died, 4 of them from disease progression and 3 from other causes. The 2-year disease-free Grade ≥3 complication-free survival was 40%. Conclusions HDR-ITB alone is a reasonable salvage treatment option in a significant number of patients with previously irradiated gynecologic tumors. |
| Databáze: | OpenAIRE |
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