PURPOSE: To retrospectively analyze results of external beam therapy (EBT) with brachytherapy (BT) for primary vaginal squamous cell carcinoma (PVSCC). MATERIALS AND METHODS: From 1970 to 2001, 91 patients were included. FIGO stages were: I (29%), II (38%), III (29%) and IVa (4%). EBT delivered a median total dose of 50 Gy to the pelvis. BT was performed with a customized intra-vaginal applicator and in 36% of applications combined endocavitary and interstitial BT. ICRU Report 38 parameters were reported. RESULTS: The 5-year cause specific survival (CSS) rates were: 83% for stage I, 76% for stage II, 52% for stage III, and 2 of the 4 stage IVa patients died 9 and 36 months after treatment. The 5-year pelvis control rates were: 79% for stage I and II and 62% for stage III. Recurrences as a first event were local only in 68% of cases, nodal only in 10%, metastatic only in 13% and combined in 9%. In multivariate analysis: stage (I and II versus II and IV), response to EBT (evaluated at BT), and the number of BT applications were statistically significant for CSS. Grade 2-3 toxicities were as follows (Franco-Italian Glossary): rectum (n=3), sigmoid colon and small bowel (n=8), bladder (n=5), ureter (n=4) and vagina (n=13). Anterior location of the tumor increased bladder toxicity (p=0.01) and total reference air kerma was higher in patients who experienced grade 2-3 urinary or digestive toxicity (p=0.03). CONCLUSION: EBT with BT is an effective treatment for patients with stage I-II PVSCC. The incidence and severity of late toxicity were relatively low. Recent advances in the treatment of cervix carcinoma emphasize the need for concomitant radio-chemotherapy in stages III-IV and the use of MRI for treatment planning.
PURPOSE: To retrospectively analyze results of external beam therapy (EBT) with brachytherapy (BT) for primary vaginal squamous cell carcinoma (PVSCC). MATERIALS AND METHODS: From 1970 to 2001, 91 patients were included. FIGO stages were: I (29%), II (38%), III (29%) and IVa (4%). EBT delivered a median total dose of 50 Gy to the pelvis. BT was performed with a customized intra-vaginal applicator and in 36% of applications combined endocavitary and interstitial BT. ICRU Report 38 parameters were reported. RESULTS: The 5-year cause specific survival (CSS) rates were: 83% for stage I, 76% for stage II, 52% for stage III, and 2 of the 4 stage IVa patients died 9 and 36 months after treatment. The 5-year pelvis control rates were: 79% for stage I and II and 62% for stage III. Recurrences as a first event were local only in 68% of cases, nodal only in 10%, metastatic only in 13% and combined in 9%. In multivariate analysis: stage (I and II versus II and IV), response to EBT (evaluated at BT), and the number of BT applications were statistically significant for CSS. Grade 2-3 toxicities were as follows (Franco-Italian Glossary): rectum (n=3), sigmoid colon and small bowel (n=8), bladder (n=5), ureter (n=4) and vagina (n=13). Anterior location of the tumor increased bladder toxicity (p=0.01) and total reference air kerma was higher in patients who experienced grade 2-3 urinary or digestive toxicity (p=0.03). CONCLUSION:EBT with BT is an effective treatment for patients with stage I-II PVSCC. The incidence and severity of late toxicity were relatively low. Recent advances in the treatment of cervix carcinoma emphasize the need for concomitant radio-chemotherapy in stages III-IV and the use of MRI for treatment planning.
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Authors: C S Gardner; J Sunil; A H Klopp; C E Devine; T Sagebiel; C Viswanathan; P R Bhosale Journal: Br J Radiol Date: 2015-05-12 Impact factor: 3.039
Authors: Hans-Georg Schnürch; Sven Ackermann; Celine D Alt-Radtke; Lukas Angleitner; Jana Barinoff; Matthias W Beckmann; Carsten Böing; Christian Dannecker; Tanja Fehm; Rüdiger Gaase; Paul Gass; Marion Gebhardt; Friederike Gieseking; Andreas Günthert; Carolin C Hack; Peer Hantschmann; Lars Christian Horn; Martin C Koch; Anne Letsch; Peter Mallmann; Bernhard Mangold; Simone Marnitz; Grit Mehlhorn; Kerstin Paradies; Michael J Reinhardt; Reina Tholen; Uwe Torsten; Wolfgang Weikel; Linn Wölber; Monika Hampl Journal: Geburtshilfe Frauenheilkd Date: 2019-07-16 Impact factor: 2.915
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