Ángeles Rovirosa1, Antonio Herreros2, Cristina Camacho2, Carlos Ascaso3, Joan Sánchez4, Stepphania Cortés2, Sebastià Sabater5, Jordi Solà2, Aureli Torné6, Meritxell Arenas7. 1. Radiation Oncology Department, Hospital Clínic i Universitari, Barcelona, Spain; Gynecological Cancer Unit, Hospital Clínic i Universitari, Barcelona, Spain. Electronic address: rovirosa@clinic.ub.es. 2. Radiation Oncology Department, Hospital Clínic i Universitari, Barcelona, Spain. 3. Basic Clinic Practice Department, Faculty of Medicine, University of Barcelona, Barcelona, Spain. 4. Economics Department, Hospital Clínic i Universitari, Barcelona, Spain. 5. Radiation Oncology Department, Hospital General de Albacete, Albacete, Spain. 6. Gynecological Cancer Unit, Hospital Clínic i Universitari, Barcelona, Spain. 7. Radiation Oncology Department, Hospital Sant Joan de Reus, Reus, Spain.
Abstract
PURPOSE: To compare vaginal control and treatment toxicity of three different high-dose-rate brachytherapy schedules as exclusive treatment in postoperative endometrial carcinoma. METHODS AND MATERIALS: From 2003 to 2015, three different schedules were used as postoperative treatment for 146 patients (p) with intermediate-risk endometrial carcinoma. Group 1 (41 p): six fractions of 4-6 Gy, 3-4 fractions per week; Group 2 (59 p): four fractions of 5-6 Gy administered daily; Group 3 (46 p): 6 Gy × 3 fractions in three consecutive days. The dose was prescribed at 5 mm of applicator surface using an active treatment length of 2.5 cm. Toxicity scores were evaluated using the Radiation Therapy Oncology Group scores for bladder and rectum and the objective criteria of late effects of normal tissues-subjective, objective, management, analytic for vagina. Statistics used were group descriptions calculating their means, medians, and ranges. Bivariate analysis was evaluated using variance models and χ2 tests. RESULTS: The mean followup was as follows: Group 1: 88 months, Group 2: 75 months, and 41 months in Group 3. No vaginal relapses were found. Late toxicity ≥ G2: rectum: 0 p in the three groups (0%). Bladder: Group 1: 1 p (2.4%), Group 2: 0%, and Group 3: 0%. Vagina: Group 1: 4 p (9.5%); Group 2: 9 p (15.3%); and Group 3:10 p (21.8%). There were no differences in late toxicity among the three groups of patients for rectum (p = 0.83), bladder (p = 0.58), and vagina (p = 0.67); the expected global risk of complications for rectum, bladder, and vagina is 0.8%, 0.8%, and 28.8%, respectively. CONCLUSIONS: Similar results in vaginal control and complications were achieved with the three schedules. The use of three fractions of 6 Gy administered daily is the best option for patient comfort and convenience and use of resources. Nonetheless, specific studies are needed to demonstrate the best cost-efficacy regime.
PURPOSE: To compare vaginal control and treatment toxicity of three different high-dose-rate brachytherapy schedules as exclusive treatment in postoperative endometrial carcinoma. METHODS AND MATERIALS: From 2003 to 2015, three different schedules were used as postoperative treatment for 146 patients (p) with intermediate-risk endometrial carcinoma. Group 1 (41 p): six fractions of 4-6 Gy, 3-4 fractions per week; Group 2 (59 p): four fractions of 5-6 Gy administered daily; Group 3 (46 p): 6 Gy × 3 fractions in three consecutive days. The dose was prescribed at 5 mm of applicator surface using an active treatment length of 2.5 cm. Toxicity scores were evaluated using the Radiation Therapy Oncology Group scores for bladder and rectum and the objective criteria of late effects of normal tissues-subjective, objective, management, analytic for vagina. Statistics used were group descriptions calculating their means, medians, and ranges. Bivariate analysis was evaluated using variance models and χ2 tests. RESULTS: The mean followup was as follows: Group 1: 88 months, Group 2: 75 months, and 41 months in Group 3. No vaginal relapses were found. Late toxicity ≥ G2: rectum: 0 p in the three groups (0%). Bladder: Group 1: 1 p (2.4%), Group 2: 0%, and Group 3: 0%. Vagina: Group 1: 4 p (9.5%); Group 2: 9 p (15.3%); and Group 3:10 p (21.8%). There were no differences in late toxicity among the three groups of patients for rectum (p = 0.83), bladder (p = 0.58), and vagina (p = 0.67); the expected global risk of complications for rectum, bladder, and vagina is 0.8%, 0.8%, and 28.8%, respectively. CONCLUSIONS: Similar results in vaginal control and complications were achieved with the three schedules. The use of three fractions of 6 Gy administered daily is the best option for patient comfort and convenience and use of resources. Nonetheless, specific studies are needed to demonstrate the best cost-efficacy regime.
Authors: Paweł Cisek; Dariusz Kieszko; Izabela Kordzińska-Cisek; Elżbieta Kutarska; Ludmiła Grzybowska-Szatkowska Journal: Biomed Res Int Date: 2018-02-21 Impact factor: 3.411
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: Y Zhang; G Gomez; C Ascaso; A Herreros; B Fornes; J Mases; J Rochera; L Tagliaferri; S Sabater; A Torne; A Biete; Á Rovirosa Journal: Clin Transl Oncol Date: 2021-12-01 Impact factor: 3.340
Authors: Garrett L Jensen; Parul N Barry; Harriet Eldredge-Hindy; Scott R Silva; Sarah L Todd; Kendall P Hammonds; Walker R Zimmerman; Daniel S Metzinger; Moataz N El-Ghamry Journal: J Contemp Brachytherapy Date: 2021-05-07
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