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Journal article
Outcomes after definitive re-irradiation with 3D brachytherapy with or without external beam radiation therapy for vaginal recurrence of endometrial cancer
Gynecologic oncology, v 152(3), pp 581-586
01 Mar 2019
PMID: 30600093
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background. Limited outcome data exists on salvage re-irradiation for vaginal relapse of previously-irradiated endometrial cancer. We report our 10-year experience with management of vaginal recurrence using definitive intent re-irradiation brachytherapy with or without EBRT.
Methods. A retrospective review was performed on 22 patients treated with definitive-intent re-irradiation brachytherapy +/- EBRT for vaginal recurrence of endometrial cancer. The cumulative rectosigmoid and bladder D2cc (EQD2) were limited to <75 Gy and <90 Gy, respectively. Kaplan-Meier and Cox proportional hazards modeling were used to estimate survival. Severe (grade 3 or higher) radiation-related toxicities, defined according to CTCAE v4, were recorded.
Results. Prior radiation therapy consisted of vaginal brachytherapy (54.5%), pelvic EBRT (22.7%), or combination pelvic EBRT and brachytherapy (22.7%). Median re-irradiation interval was 26.6 months. Salvage re irradiation consisted of EBRT with brachytherapy in 50.0% and brachytherapy alone in 50.0%. Median HR-CTV D90 (EQD2) was 64.5 Gy (IQR: 49.6-75.8). Median cumulative D2cc for bladder, rectum, and sigmoid were 72.1 Gy (range: 30.3-81.8), 70.6 Gy (range: 32.0-80.5), and 52.7 Gy (range: 29.6-75.3), respectively. At a median follow-up of 27.6 months, 3-year local control, regional control, disease-free survival, and overall survival rates were 65.8%, 76.6%, 40.8%, and 68.1%, respectively. There were no grade >= 3 acute or late rectosigmoid or bladder toxicities.
Conclusion. Re-irradiation with 3D conformal brachytherapy for vaginal recurrence is feasible and safe as long as cumulative dose to surrounding normal organs is limited, and offers a chance to potentially salvage 40% of patients presenting with vaginal recurrence in the setting of prior pelvic radiation. (C) 2019 Elsevier Inc. All rights reserved.
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Details
- Title
- Outcomes after definitive re-irradiation with 3D brachytherapy with or without external beam radiation therapy for vaginal recurrence of endometrial cancer
- Creators
- Diane C. Ling - UPMC Hillman Cancer CenterJohn A. Vargo - UPMC Hillman Cancer CenterScott M. Glaser - UPMC Hillman Cancer CenterHayeon Kim - UPMC Hillman Cancer CenterSushil Beriwal - UPMC Hillman Cancer Center
- Publication Details
- Gynecologic oncology, v 152(3), pp 581-586
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- U54 GM104942 / NIGMS NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of General Medical Sciences (NIGMS)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000461726100023
- Scopus ID
- 2-s2.0-85059174257
- Other Identifier
- 991021897367304721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Obstetrics & Gynecology
- Oncology