Rei Umezawa1, Naoya Murakami2, Satoshi Nakamura2, Akihisa Wakita2, Hiroyuki Okamoto2, Keisuke Tsuchida2, Tairo Kashihara2, Kazuma Kobayashi2, Ken Harada2, Kana Takahashi2, Koji Inaba2, Yoshinori Ito2, Hiroshi Igaki2, Koji Masui3, Ken Yoshida4, Keiichi Jingu5, Nikolaos Tselis6, Jun Itami2. 1. Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: reirei513@hotmail.com. 2. Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan. 3. Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan. 4. Department of Radiology, Osaka Medical College Hospital, Osaka, Japan. 5. Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan. 6. Department of Radiotherapy and Oncology, University of Frankfurt, Frankfurt am Main, Germany.
Abstract
PURPOSE: The aim of this study was to investigate the efficacy and safety of image-guided high-dose-rate (HDR) interstitial brachytherapy (ISBT) for reirradiation of locally recurrent uterine cervical cancer. METHODS AND MATERIALS: Between 2008 and 2015, patients receiving reirradiation using HDR-ISBT for local gross recurrence of uterine cervical cancer after definitive or postoperative radiotherapy were analyzed retrospectively. The prescription doses per fraction ranged 2.5-6.0 Gy, whereas the cumulative equivalent doses in 2 Gy fractions ranged 48.6-82.5 Gy. The effects of prognostic factors on the local control (LC), progression-free survival, and overall survival were analyzed, and late toxicity data were evaluated. RESULTS: Eighteen patients were included in the analysis, with a median followup of 18.1 months. A tumor response was obtained in all patients, with radiological and pathological complete remission seen in 12 (66.7%) patients. The 2-year LC, progression-free survival, and overall survival rates for all patients were 51.3%, 20.0%, and 60.8%, respectively. The hemoglobin level and maximum tumor diameter were shown to be statistically significant prognostic factors for LC (p = 0.028 and 0.009, respectively). Late ≥ Grade 2 adverse events were observed in 5 patients (27.8%). CONCLUSIONS: Image-guided HDR-ISBT for the reirradiation of locally recurrent uterine cervical cancer may play an important role for local tumor control in a subgroup of patients. However, the treatment indication must be weighed against the risk of higher-grade late toxicity.
PURPOSE: The aim of this study was to investigate the efficacy and safety of image-guided high-dose-rate (HDR) interstitial brachytherapy (ISBT) for reirradiation of locally recurrent uterine cervical cancer. METHODS AND MATERIALS: Between 2008 and 2015, patients receiving reirradiation using HDR-ISBT for local gross recurrence of uterine cervical cancer after definitive or postoperative radiotherapy were analyzed retrospectively. The prescription doses per fraction ranged 2.5-6.0 Gy, whereas the cumulative equivalent doses in 2 Gy fractions ranged 48.6-82.5 Gy. The effects of prognostic factors on the local control (LC), progression-free survival, and overall survival were analyzed, and late toxicity data were evaluated. RESULTS: Eighteen patients were included in the analysis, with a median followup of 18.1 months. A tumor response was obtained in all patients, with radiological and pathological complete remission seen in 12 (66.7%) patients. The 2-year LC, progression-free survival, and overall survival rates for all patients were 51.3%, 20.0%, and 60.8%, respectively. The hemoglobin level and maximum tumor diameter were shown to be statistically significant prognostic factors for LC (p = 0.028 and 0.009, respectively). Late ≥ Grade 2 adverse events were observed in 5 patients (27.8%). CONCLUSIONS: Image-guided HDR-ISBT for the reirradiation of locally recurrent uterine cervical cancer may play an important role for local tumor control in a subgroup of patients. However, the treatment indication must be weighed against the risk of higher-grade late toxicity.
Authors: Sophie Bockel; Sophie Espenel; Roger Sun; Isabelle Dumas; Sébastien Gouy; Philippe Morice; Cyrus Chargari Journal: Cancers (Basel) Date: 2021-03-11 Impact factor: 6.639