Journal article
Definitive salvage for vaginal recurrence of endometrial cancer: The impact of modern intensity-modulated-radiotherapy with image-based HDR brachytherapy and the interplay of the PORTEC 1 risk stratification
Radiotherapy and oncology, v 113(1), pp 126-131
01 Oct 2014
PMID: 25241996
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Data for salvage radiotherapy for recurrent endometrial cancer are limited especially in the era of modern radiotherapy including IMRT and 3-dimensional image-based HDR brachytherapy. Theoretically, modern radiotherapy reduces the dose to critical organs-at-risk and maximizes dose to the target volume, possibly decreasing morbidity and increasing tumor control.
Forty-one patients completing definitive salvage radiotherapy for vaginal recurrence of endometrial cancer from June 2004 to December 2013 were retrospectively reviewed. HDR Brachytherapy was completed using image-based planning with contouring/optimization with each fraction to a median dose of 23.75Gy in 5 fractions. HDR brachytherapy was preceded by external beam radiotherapy predominately using an IMRT technique (90%) to a median dose of 45Gy in 25 fractions. Toxicity was reported according to CTCAEv4.
At a median follow-up of 18months (range: 3–78), the clinical complete response rate was 95%. The 3-year local control, distant control, recurrence free survival, and overall survival were 95%, 61%, 68%, and 67%. Significant predictors of both distant failure and overall survival were primary prognostic factors of depth of myometrial invasion, FIGO stage, and FIGO grade. There was no grade 3+ acute toxicity; the 3-year rate of grade 3+ late toxicity was 8%.
Salvage IMRT plus 3-dimensional image-based HDR brachytherapy shows excellent tumor control and minimal morbidity for vaginal recurrence of endometrial cancer. Anticipated salvage rates must be taken in the context of primary risk factors including depth of myometrial invasion, FIGO stage, and FIGO grade.
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Details
- Title
- Definitive salvage for vaginal recurrence of endometrial cancer: The impact of modern intensity-modulated-radiotherapy with image-based HDR brachytherapy and the interplay of the PORTEC 1 risk stratification
- Creators
- John A. Vargo - UPMC Hillman Cancer CenterHayeon Kim - UPMC Hillman Cancer CenterChristopher J. Houser - UPMC Hillman Cancer CenterHebist Berhane - UPMC Hillman Cancer CenterPaniti Sukumvanich - Gynecologic Oncology GroupAlexander B. Olawaiye - Gynecologic Oncology GroupJoseph L. Kelley - Gynecologic Oncology GroupRobert P. Edwards - Gynecologic Oncology GroupJohn T. Comerci - Gynecologic Oncology GroupMarilyn Huang - Gynecologic Oncology GroupMadeleine Courtney-Brooks - Department of Gynecologic Oncology, Pittsburgh, United StatesSushil Beriwal - UPMC Hillman Cancer Center
- Publication Details
- Radiotherapy and oncology, v 113(1), pp 126-131
- Publisher
- Elsevier Ireland Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000347604800021
- Scopus ID
- 2-s2.0-84922598070
- Other Identifier
- 991021897395404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging