Angeles Rovirosa1, Carlos Ascaso2, Meritxell Arenas3, Sebastia Sabater4, Antonio Herreros5, Albert Camarasa5, Ivan Rios6, Katarzyna Holub5, Jaume Pahisa7, Albert Biete5. 1. Radiation Oncology Dpt., ICMHO, Functional Gynecologic Cancer Unit, Hospital Clinic Universitari, Barcelona, Spain. Electronic address: rovirosa@clinic.ub.es. 2. Public and Health Dpt., Medicine Faculty, Universitat de Barcelona, Spain. 3. Radiation Oncology Dpt., Hospital Sant Joan de Reus, Tarragona, Spain. 4. Radiation Oncology Dpt., Hospital General de Albacete, Spain. 5. Radiation Oncology Dpt., ICMHO, Functional Gynecologic Cancer Unit, Hospital Clinic Universitari, Barcelona, Spain. 6. Radiation Oncology Dpt., ICMHO, Functional Gynecologic Cancer Unit, Hospital Clinic Universitari, Barcelona, Spain; Radiation Oncology Dpt., Centro Médico Imbanaco, Cali, Colombia. 7. Gynecological Surgery, Functional Gynecologic Cancer Unit, Hospital Clinic Universitari, Barcelona, Spain.
Abstract
PURPOSE: To analyze vaginal-cuff relapses (VCR) and toxicity of two brachytherapy (BT) schedules in postoperative endometrial carcinoma and to correlate vaginal toxicity with vaginal-surface-EQD2Gy3 dose (VS-EQD2Gy3). METHODS/MATERIALS: 319 patients (p) I-IIIC-Figo-stage were treated with 2 BT schedules. One schedule included 166p (Group-1) to whom 3 fractions (Fr) of 4-6Gy per week (w) of BT were administered after external beam radiotherapy (EBI) (125p) and 6Fr/2w of 4-6Gy in exclusive-BT (41p). The second schedule included 153p (Group-2) with BT administered daily with 2Fr/w of 5-6Gy after EBI (94p) and 5-6Gy/4Fr/w in exclusive-BT (59p). Doses were prescribed at 5mm from the vaginal surface. Toxicity was evaluated using RTOG scores for the rectum and bladder and objective LENT-SOMA scores for the vagina. STATISTICS: Chi-square, Fisher and Student's-t tests. RESULTS: Mean follow-up (months): Group-1: 66.55 (7.73-115.40), Group-2: 41.49 (3.13-87.90). VCR: Group-1: 3p (1.88%); Group-2: 2p (1.3%). No differences were found between the two schedules comparing rectal (p=0.170), bladder (p=0.125) and vagina (p=0.680) late toxicities and comparing vagina EBI+BTp vs. exclusive-BTp (p=0.667). Significant differences in VS-EQD23Gy were observed considering EBI+BT (Groups 1+2) vs. exclusive-BT (Groups 1+2) (p<0.0001); nevertheless, no association was found between VS-EQD23Gy and vaginal complications. CONCLUSIONS: No differences were found between the two schedules. No association was found between vaginal toxicity and VS-EQD23Gy. Consequently, treatment with the least number of fractions is preferable.
PURPOSE: To analyze vaginal-cuff relapses (VCR) and toxicity of two brachytherapy (BT) schedules in postoperative endometrial carcinoma and to correlate vaginal toxicity with vaginal-surface-EQD2Gy3 dose (VS-EQD2Gy3). METHODS/MATERIALS: 319 patients (p) I-IIIC-Figo-stage were treated with 2 BT schedules. One schedule included 166p (Group-1) to whom 3 fractions (Fr) of 4-6Gy per week (w) of BT were administered after external beam radiotherapy (EBI) (125p) and 6Fr/2w of 4-6Gy in exclusive-BT (41p). The second schedule included 153p (Group-2) with BT administered daily with 2Fr/w of 5-6Gy after EBI (94p) and 5-6Gy/4Fr/w in exclusive-BT (59p). Doses were prescribed at 5mm from the vaginal surface. Toxicity was evaluated using RTOG scores for the rectum and bladder and objective LENT-SOMA scores for the vagina. STATISTICS: Chi-square, Fisher and Student's-t tests. RESULTS: Mean follow-up (months): Group-1: 66.55 (7.73-115.40), Group-2: 41.49 (3.13-87.90). VCR: Group-1: 3p (1.88%); Group-2: 2p (1.3%). No differences were found between the two schedules comparing rectal (p=0.170), bladder (p=0.125) and vagina (p=0.680) late toxicities and comparing vagina EBI+BTp vs. exclusive-BTp (p=0.667). Significant differences in VS-EQD23Gy were observed considering EBI+BT (Groups 1+2) vs. exclusive-BT (Groups 1+2) (p<0.0001); nevertheless, no association was found between VS-EQD23Gy and vaginal complications. CONCLUSIONS: No differences were found between the two schedules. No association was found between vaginal toxicity and VS-EQD23Gy. Consequently, treatment with the least number of fractions is preferable.
Authors: Á Rovirosa; K S Cortés; C Ascaso; A Glickman; S Valdés; A Herreros; C Camacho; J Sánchez; Y Zhang; Y Li; S Sabater; M Arenas; A Torne Journal: Clin Transl Oncol Date: 2018-04-12 Impact factor: 3.405
Authors: Jessica D Arden; Jonathan Dokter; Muayad F Almahariq; Kimberly Marvin; Sirisha R Nandalur; Zaid Al-Wahab; Jill Gadzinski; Barry Rosen; Maha Saada Jawad Journal: Adv Radiat Oncol Date: 2021-08-12
Authors: María Del Valle Aguilera; Ángeles Rovirosa; Carlos Ascaso; Antonio Herreros; Joan Sánchez; Julia Garcia-Migue; Stephanía Cortes; Eduardo Agusti; Cristina Camacho; Yaowen Zhang; Yan Li; Sebastià Sabater; Aureli Torne; Meritxell Arenas Journal: J Contemp Brachytherapy Date: 2018-02-28
Authors: Vitaliana De Sanctis; Daniela Musio; Francesca De Felice; Francesco Marampon; Maurizio Valeriani; Paolo Bonome; Dimitri Anzellini; Giuseppe Facondo; Gianluca Vullo; Maria Massaro; Mario Di Staso; Pierluigi Bonfili; Agnieszka Chalaszczyk; Giovanni Luca Gravina; Vincenzo Tombolini; Mattia Falchetto Osti Journal: J Contemp Brachytherapy Date: 2020-04-30