Journal article
High-dose-rate interstitial brachytherapy for gynecologic malignancies
Brachytherapy, v 5(4), pp 218-222
01 Oct 2006
PMID: 17118313
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
PURPOSE: The study aimed to assess the outcome of locally advanced cervical and vaginal cancer treated with high-close-rate interstitial brachytherapy (HDRB).
METHODS AND MATERIALS: Between 1998 and 2004, 16 previously unirradiated patients with locally advanced cervical and vaginal cancer not suitable for intracavitary brachytherapy because of distorted anatomy or extensive vaginal disease were treated with HDRB in combination with external beam radiotherapy. All patients received whole pelvis external beam radiation therapy (EBRT) followed by interstitial implantation. The median whole pelvis external beam dose was 45 Gy (range, 39.6-50.4 Gy) with 11 patients receiving parametrial boost to a median dose of 9 Gy. Twelve (75%) of these patients received chemotherapy concurrent with external beam. All patients received a single HDRB procedure using a modified Syed-Neblett template. A CT scan was performed postimplant for needle placement verification and treatment planning purpose. Dose was prescribed to the tumor volume based on the radiographic and clinical examination. All patients received 18.75 Gy in five fractions delivered twice daily. The median followup was 25 months (6-69 months).
RESULTS: Median cumulative biologic effective dose (EBRT + HDRB) to tumor volume was 78.9 Gy(10) with the range of 72.5-85.2 Gy(10). Median cumulative biologic effective dose for the rectum and bladder were 99.4 Gy(3) (range, 79.6-107.8 Gy(3)) and 96.4 Gy(3) (range, 78.3-105.3 Gy(3)) respectively. Complete response was achieved in 13 (81%) patients with 3 patients having persistent disease. Five of these 13 patients developed recurrence at a median time of 14 months (distant in 4 and local and distant in 1). The 5-year actuarial local control and cause-specific survival were 75% and 64%, respectively. In subset analysis, 5-year actuarial local control was 63% for cervical cancer patients and 100% for vaginal cancer patients. No patient had acute Grade 3 or 4 morbidity. Grade 3 or 4 delayed morbidity resulting from treatment occurred in I patient with 5-year actuarial rate of 7%. Three patients had late Grade 2 rectal morbidity and I patient had Grade 2 small bowel morbidity.
CONCLUSIONS: Our series suggests that single interstitial implantation procedure with five fractions of 3.75 Gy each to target volume is an effective and safe fractionation schedule. The integration of imaging modality helps in decreasing close to the critical organs. Additional patients and followup are ongoing to determine the long-term efficacy of this approach. (C) 2006 American Brachytherapy Society. All rights reserved.
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Details
- Title
- High-dose-rate interstitial brachytherapy for gynecologic malignancies
- Creators
- Sushil Beriwal - UPMC Hillman Cancer CenterAjay Bhatnagar - University of PittsburghDwight E. Heron - University of PittsburghRaj Selvaraj - University of PittsburghRobert Mogus - University of PittsburghHayeon Kim - University of PittsburghKristina Gerszten - University of PittsburghJoseph Kelley - University of PittsburghRobert P. Edwards - University of Pittsburgh
- Publication Details
- Brachytherapy, v 5(4), pp 218-222
- Publisher
- Elsevier
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000207065400004
- Scopus ID
- 2-s2.0-33750966735
- Other Identifier
- 991021897291104721
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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