Journal article
Outcomes of 3D MRI based HDR brachytherapy with hybrid multichannel vaginal cylinder applicator and freehand needles for treatment of vaginal disease
Brachytherapy, v 22(1), pp 66-71
Jan 2023
PMID: 36266203
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Freehand needles can be used with multichannel vaginal cylinders (MCVC) to cover vaginal cancer >7 mm thick or with supra-vaginal extension. We report our institutional outcomes using this novel hybrid technique.
Patients with vaginal malignancies treated with HDR BT using MCVC plus freehand needles from 2014-2021 at our institution were identified. Clinical characteristics, details of brachytherapy, initial response, and overall local control (LC) outcomes were recorded. LC was analyzed via Kaplan-Meier method.
34 patients were identified with median follow-up 1.9 years. 19 patients had primary endometrial cancer with vaginal recurrence/disease, and remaining had primary vaginal cancer or other primaries. 7 patients had recurrence after previous RT course. 25 patients received EBRT with median dose 45 Gy in 25 fractions, and rest received BT alone. Median HR-CTV D90 for patients treated with EBRT plus BT was 77.4 Gy.
30 patients had complete local response to BT on initial examination and/or follow-up imaging. 1 and 2-year LC rates in patients without prior RT treated with EBRT + BT were 94.1% and 94.1%, respectively. 1 and 2-year LC rates for those without prior RT were 88.1% and 76.4%, respectively. 1 and 2-year LC rates for those with prior RT were 68.6% and 34.3%, respectively. 1 patient had vaginal laceration requiring surgical repair, and 1 patient developed small bowel obstruction 1 month after BT, with no additional acute grade 3+ toxicities identified.
Our approach with MCVC plus freehand needles with MRI-based planning was feasible and safe, with excellent initial local response and low rate of serious toxicities.
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Details
- Title
- Outcomes of 3D MRI based HDR brachytherapy with hybrid multichannel vaginal cylinder applicator and freehand needles for treatment of vaginal disease
- Creators
- Ria Mulherkar - UPMC Hillman Cancer CenterAndrew Keller - Florida Hospital Cancer InstituteChristopher J. Houser - UPMC Hillman Cancer CenterHayeon Kim - UPMC Hillman Cancer CenterElangovan Doraisamy - UPMC Hillman Cancer CenterTanvir Baig - UPMC Hillman Cancer CenterParul Barry - UPMC Hillman Cancer CenterJohn A. Vargo - UPMC Hillman Cancer CenterSushil Beriwal - Allegheny Health Network
- Publication Details
- Brachytherapy, v 22(1), pp 66-71
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000964862400001
- Scopus ID
- 2-s2.0-85140776590
- Other Identifier
- 991021897274604721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging