Ben G L Vanneste1, Philip Meijnen2, Chris S J Hammerstein3, Nina Bijker3, Rob M van Os3, Lukas J A Stalpers3, Bradley R Pieters3. 1. Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Radiation Oncology, MAASTRO Clinic, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands. Electronic address: ben.vanneste@maastro.nl. 2. Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands; Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
Abstract
BACKGROUND: To evaluate the rate of vaginal, pelvic, and distant failures and acute toxicity after postoperative vaginal vault brachytherapy (VBT) delivered by a ring applicator in women with high intermediate-risk endometrial cancer. METHODS AND MATERIALS: A total of 100 patients were treated with VBT after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a Stage IA or IB (International Federation of Gynecology and Obstetrics 2009) intermediate-risk endometrial cancer; 26 patients received 30-Gy low-dose-rate, 74 patients received 28-Gy pulsed-dose-rate brachytherapy. RESULTS: At a median followup of 37 months (range, 1-107), 6 (6%) patients showed failures. Three patients developed an in-field recurrence in the vaginal vault: 1 was isolate, whereas the other 2 showed simultaneous pelvic and/or distant failure. A fourth patient developed an out-of-field recurrence in the posterior vaginal wall of the proximal half of the vagina, including pelvic and distant failure. Two other patients showed only distant failure. The estimated 3-year actuarial rate of any vaginal recurrence was 2.6% (95% confidence interval, 0-6.3%). The 5-year overall survival was 84%, similar to that in the female Dutch population matched for age and date of diagnosis. The acute side effects were low, consisting mainly of the occurrence of temporary diarrhea (2%). CONCLUSION: Postoperative VBT by a ring applicator results in a low recurrence risk, survival rates comparable with the normal female population, and a very low risk of acute morbidity.
BACKGROUND: To evaluate the rate of vaginal, pelvic, and distant failures and acute toxicity after postoperative vaginal vault brachytherapy (VBT) delivered by a ring applicator in women with high intermediate-risk endometrial cancer. METHODS AND MATERIALS: A total of 100 patients were treated with VBT after a total abdominal hysterectomy and bilateral salpingo-oophorectomy for a Stage IA or IB (International Federation of Gynecology and Obstetrics 2009) intermediate-risk endometrial cancer; 26 patients received 30-Gy low-dose-rate, 74 patients received 28-Gy pulsed-dose-rate brachytherapy. RESULTS: At a median followup of 37 months (range, 1-107), 6 (6%) patients showed failures. Three patients developed an in-field recurrence in the vaginal vault: 1 was isolate, whereas the other 2 showed simultaneous pelvic and/or distant failure. A fourth patient developed an out-of-field recurrence in the posterior vaginal wall of the proximal half of the vagina, including pelvic and distant failure. Two other patients showed only distant failure. The estimated 3-year actuarial rate of any vaginal recurrence was 2.6% (95% confidence interval, 0-6.3%). The 5-year overall survival was 84%, similar to that in the female Dutch population matched for age and date of diagnosis. The acute side effects were low, consisting mainly of the occurrence of temporary diarrhea (2%). CONCLUSION: Postoperative VBT by a ring applicator results in a low recurrence risk, survival rates comparable with the normal female population, and a very low risk of acute morbidity.
Authors: Brian V Balgobind; Kees Koedooder; Diego Ordoñez Zúñiga; Raquel Dávila Fajardo; Coen R N Rasch; Bradley R Pieters Journal: Br J Radiol Date: 2015-08-20 Impact factor: 3.039
Authors: Matthew M Harkenrider; Alec M Block; Kaled M Alektiar; David K Gaffney; Ellen Jones; Ann Klopp; Akila N Viswanathan; William Small Journal: Brachytherapy Date: 2016-05-31 Impact factor: 2.362