Perioperative high-dose-rate brachytherapy in locally advanced and recurrent gynecologic cancer: Initial results of a phase II trial
| Autor: | Mauricio Cambeiro, E. Villafranca, Matías Jurado, Juan Luis Alcázar, Jeanette Valero, Rafael Martínez-Monge |
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| Rok vydání: | 2006 |
| Předmět: |
0301 basic medicine
Adult medicine.medical_specialty Colorectal cancer Genital Neoplasms Female medicine.medical_treatment Brachytherapy Salvage therapy Perioperative Care 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Adverse effect Survival rate Aged Salvage Therapy business.industry Retrospective cohort study Perioperative Middle Aged medicine.disease Combined Modality Therapy High-Dose Rate Brachytherapy Surgery Survival Rate 030104 developmental biology Treatment Outcome Oncology 030220 oncology & carcinogenesis Feasibility Studies Female Neoplasm Recurrence Local business |
| Zdroj: | Brachytherapy. 5(4) |
| ISSN: | 1538-4721 |
| Popis: | Purpose To determine the long-term results of a Phase II trial of perioperative high-dose-rate brachytherapy (PHDRB) in primary advanced or recurrent gynecological cancer. Methods and Materials Fifty patients with locally advanced and recurrent gynecological cancer suitable for salvage surgery were included. Unirradiated patients (n = 25) received preoperative chemoradiation followed by surgery and PHDRB (16–24 Gy). Previously irradiated patients (n = 25) received surgery and PHDRB alone (32–40 Gy). Results Median followup was 11.5 years. Eight unirradiated patients (32%) developed Grade ≥3 toxic events including two fatal events. Local and locoregional control rates at 16 years were 87.3% and 78.9%, respectively. Sixteen-year disease-free and overall survival rates were 42.9% and 46.4%, respectively. Ten previously irradiated patients (40.0%) developed Grade ≥3 adverse events, including four fatal events. Local and locoregional control rates at 14 years were 59.6% and 42.6%, respectively. Fourteen-year disease-free and overall survival rates were 16.0% and 19.2%, respectively. Conclusions PHDRB allows effective salvage of a subset of unfavorable gynecological tumors with high-risk surgical margins. Toxicity was unacceptable at the initial dose levels but deescalation resulted in the absence of severe toxicity without a negative impact on locoregional control. A substantial percentage of patients remain alive and controlled at >10 years including a few previously irradiated cases with positive margins. |
| Databáze: | OpenAIRE |
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