Journal article
Image-guided tandem and cylinder brachytherapy as monotherapy for definitive treatment of inoperable endometrial carcinoma
Gynecologic oncology, v 147(2), pp 302-308
Nov 2017
PMID: 28923412
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
•Many women are unable to undergo standard surgical staging for endometrial cancer.•Women with low-volume disease were treated with 3D-image guided brachytherapy alone.•Two-year overall and cancer-specific survival rates were 90% and 97%, respectively.•No grade 3+ acute or late toxicity was observed.•Brachytherapy is an alternative approach in low-volume disease inoperable women.
Management of endometrial cancer consists of surgical staging with adjuvant therapy guided by risk factors, though some women cannot undergo surgery due to comorbidities. We present a series of women treated with definitive high-dose rate image-guided tandem and cylinder brachytherapy (HDR-IGBT) alone.
Patients with grade 1–2, clinical stage I endometrial adenocarcinoma, <50% myometrial invasion, and tumor≤2cm were reviewed. Definitive treatment consisted of 5–6 fractions HDR-IGBT alone with CT- or MRI-based planning. Local-regional control (LRC) was defined as complete imaging response and/or cessation of vaginal bleeding.
From 2007 to 2016, 45 patients were treated to a median dose of 37.5Gy. The median gross tumor volume (GTV) and clinical target volume (CTV) were 5.9cm3 (range, 0.7–18.7) and 80.9cm3 (17.2–159.0), respectively. The median cumulative dose to 90% (D90) of the GTV was 132.8Gy (76.5–295.6) equivalent 2Gy dose, and the median CTV D90 was 49.7Gy (34.5–57.2). Median follow-up among living patients was 18.6months (3.0–64.3). Cessation of vaginal bleeding occurred in 98%. Among those with post-treatment MRI (64%), complete radiographic response was demonstrated in 90%. The 2-year LRC, cancer-specific survival, and overall survival rates were 90%, 86%, and 97%, respectively. No grade 3+ acute or late toxicity was observed.
HDR-IGBT alone for treatment of early-stage, medically inoperable endometrial cancer is feasible with excellent response rates and clinical results. This approach also allows sparing of critical organs and ensures target coverage, which contributed to the low toxicity rate and high LRC in comparison with 2D point-based series.
Metrics
Details
- Title
- Image-guided tandem and cylinder brachytherapy as monotherapy for definitive treatment of inoperable endometrial carcinoma
- Creators
- Brian Gebhardt - UPMC Hillman Cancer CenterBeant Gill - UPMC Hillman Cancer CenterScott Glaser - UPMC Hillman Cancer CenterHayeon Kim - UPMC Hillman Cancer CenterChris Houser - UPMC Hillman Cancer CenterJoseph Kelley - UPMC Hillman Cancer CenterPaniti Sukumvanich - UPMC Hillman Cancer CenterRobert Edwards - UPMC Hillman Cancer CenterJohn Comerci - UPMC Hillman Cancer CenterAlexander Olawaiye - UPMC Hillman Cancer CenterMadeleine Courtney-Brooks - UPMC Hillman Cancer CenterMichelle Boisen - UPMC Hillman Cancer CenterJessica Berger - UPMC Hillman Cancer CenterSushil Beriwal - UPMC Hillman Cancer Center
- Publication Details
- Gynecologic oncology, v 147(2), pp 302-308
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000415663600012
- Scopus ID
- 2-s2.0-85029406400
- Other Identifier
- 991021897290404721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Obstetrics & Gynecology
- Oncology