Yaowen Zhang1,2, Carlos Ascaso1, Antonio Herreros1,2, Joan Sánchez3, Sebastia Sabater4, Marta Del Pino5, Yan Li1,2, Gabriela Gómez2,6, Aureli Torné5, Albert Biete1,2,5, Ángeles Rovirosa1,2,5. 1. Fonaments Clinics Dpt. University of Barcelona, 08036 Barcelona, Spain. 2. Radiation Oncology Dpt. Hospital Clinic Universitari, 08036, Barcelona, Spain. 3. Economics Dpt. Hospital Clinic Universitari, 08036, Barcelona, Spain. 4. Radiation Oncology Dpt. Hospital General Universitario de Albacete, 02006 Albacete, Spain. 5. Gynecological Cancer Unit. Hospital Clinic Universitari, 08036 Barcelona, Spain. 6. Radiation Oncology Dpt. Instituto Nacional de Cancerología, Ciudad de México, Mexico.
Abstract
AIM: To analyse the possible relationship between the EQD2(α/β=3Gy) at 2 cm3 of the vagina and late toxicity in vaginal-cuff-brachytherapy (VBT) after external-beam-irradiation (EBRT) for postoperative endometrial carcinoma (EC). MATERIALS AND METHODS: From 2014 to 2016, 62 postoperative EC patients were treated with EBRT + VBT. The median EBRT dose was 45 Gy (44 Gy-50.4 Gy). VBT involved a single 7 Gy dose. Toxicity was prospectively evaluated using the RTOG score for the rectum and bladder and the objective LENT-SOMA criteria for the vagina. EQD2(α/β = 3Gy) at 2 cm3 of the most exposed part of the vagina was calculated by the sum of the EBRT + VBT dose. Statistics: Boxplot, Student's t and Chi-square tests and ROC curves. RESULTS: Mean follow-up: 39.2 months (15-68). Late toxicity: bladder:0 patient; rectum:2 patients-G1; Vagina: 26 patients-17G1, 9G2; median EQD2(α/β=3Gy) at 2 cm3 in G0-G1 patients was 70.4 Gy(SD2.36), being 72.5 Gy(SD2.94) for G2p. The boxplot suggested a cut-point identifying the absence of G2: 100 % of G2p received >68 Gy, ROC curves showed an area under the curve of 0.72 (sensitivity of 1 and specificity of 0.15). CONCLUSIONS: Doses >68 Gy EQD2(α/β=3Gy) at 2 cm3 to the most exposed area of the vagina were associated with late G2 vaginal toxicity in postoperative EC patients treated with EBRT + VBT suggesting a very good dose limit to eliminate the risk of G2 late toxicity. The specificity obtained indicates the need for prospective analyses.
AIM: To analyse the possible relationship between the EQD2(α/β=3Gy) at 2 cm3 of the vagina and late toxicity in vaginal-cuff-brachytherapy (VBT) after external-beam-irradiation (EBRT) for postoperative endometrial carcinoma (EC). MATERIALS AND METHODS: From 2014 to 2016, 62 postoperative EC patients were treated with EBRT + VBT. The median EBRT dose was 45 Gy (44 Gy-50.4 Gy). VBT involved a single 7 Gy dose. Toxicity was prospectively evaluated using the RTOG score for the rectum and bladder and the objective LENT-SOMA criteria for the vagina. EQD2(α/β = 3Gy) at 2 cm3 of the most exposed part of the vagina was calculated by the sum of the EBRT + VBT dose. Statistics: Boxplot, Student's t and Chi-square tests and ROC curves. RESULTS: Mean follow-up: 39.2 months (15-68). Late toxicity: bladder:0 patient; rectum:2 patients-G1; Vagina: 26 patients-17G1, 9G2; median EQD2(α/β=3Gy) at 2 cm3 in G0-G1 patients was 70.4 Gy(SD2.36), being 72.5 Gy(SD2.94) for G2p. The boxplot suggested a cut-point identifying the absence of G2: 100 % of G2p received >68 Gy, ROC curves showed an area under the curve of 0.72 (sensitivity of 1 and specificity of 0.15). CONCLUSIONS: Doses >68 Gy EQD2(α/β=3Gy) at 2 cm3 to the most exposed area of the vagina were associated with late G2 vaginal toxicity in postoperative EC patients treated with EBRT + VBT suggesting a very good dose limit to eliminate the risk of G2 late toxicity. The specificity obtained indicates the need for prospective analyses.
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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: 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: Antonio Herreros; José Pérez-Calatayud; Facundo Ballester; Jose Barrera-Gómez; Rosa Abellana; Joana Melo; Luis Moutinho; Luca Tagliaferri; Ángeles Rovirosa Journal: J Pers Med Date: 2022-05-31
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