Exclusive 3D‑brachytherapy as a good option for stage‑I inoperable endometrial cancer: a retrospective analysis in the gynaecological cancer GEC‑ESTRO Working Group

• ngeles Rovirosa ^[1] ; Yaowen Zhang ^[5] ; Cyrus Chargari ^[6] ; Rachel Cooper ^[7] ; Peter Bownes ^[7] ; Piotr Wojcieszek ^[8] ; Magdalena Stankiewicz ^[8] ; Peter Hoskin ^[9] ; Elzbieta Van der Steen Banasik ^[10] ; Barbara Segedin ^[11] ; Dina Najjari ^[2] ; Richard Pötter ^[3] ; Kari Tanderup ^[4] ; Erik Van Limbergen ^[12]
  1. [1] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  2. [2] Institute Catalá Oncología

     Institute Catalá Oncología

     Barcelona, España

     
  3. [3] Medical University of Vienna

     Medical University of Vienna

     Innere Stadt, Austria

     
  4. [4] Aarhus University

     Aarhus University

     Dinamarca

     
  5. [5] Cancer Center, Henan Provincial People’s Hospital, Zhengzhou, China
  6. [6] adiation Oncology Department, Institute Gustave Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif Cedex, France
  7. [7] Leeds Cancer Centre, Beckett Street, Leeds LS9 7TF, UK
  8. [8] Maria Sklodowska-Curie National Research Institute of Oncology, Oddział w Gliwicach Ul Wybrzeże Armii Krajowej, 15 44-102 Gliwice, Poland
  9. [9] Mount Vernon Cancer Centre, Rickmansworth Rd, Northwood HA6 2RN, UK
  10. [10] Radiotherapie Groep/Arnhem, Radiation Oncology Department, Wagnerlaan 47, 6815 AD Arnhem, The Netherlands
  11. [11] nstitute of Oncology of Ljubljana, Zaloška cesta 2, 1000 Ljubljana, Slovenia
  12. [12] Radiation Oncology Department, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 2, 2022, págs. 254-265
• Idioma: inglés
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  • Purpose Analyse outcomes of stage-I inoperable endometrial cancer (EC) patients from seven European centres treated with 3D-image-guided brachytherapy (IGBT) alone.

    Materials and methods From 2004 to 2018, 62 patients (41 stage-IA and 21 IB) were retrospectively studied, analysing anaesthetic procedure, applicator type, BT-planning imaging, clinical target volume (CTV), BT schedule, overall daily-dose equivalent to 2 Gy (EQD2(α/β=4.5 or 3)) to the CTV(α/β=4.5) and D2 cm3(α/β=3) for organs at risk. Complications were evaluated using CTCAEv4 scores. The 2 and 5 year survival was calculated [cancer-specific survival (CSS), disease-free survival (DFS), local relapse-free survival (LRFS), loco-regional relapse-free survival (LRRFS) and distant metastasis-free survival (DMFS)]. Descriptive analysis and the Kaplan–Meier method were used for survival analysis.

    Results Mean follow-up: 32.8 months (SD 33.7). Spinal anaesthesia (38/62) followed by none (16/62) were the most com- mon. Y-shaped Rotte applicators were used in 74% of patients. High-dose rate brachytherapy was administered in 89%.

    Median D90 to the CTV was 58.9 Gy (8.66–144 Gy). Eight patients presented relapse: four uterine, four nodal and four distant. The 2 and 5 year CSS was 93.3 and 80.5%, DFS 84.8 and 80.5%, LRFS was 93.1 and 88.7%, LRRFS was 91 and 91% and DMFS was 90.2 and 90.2%, respectively, CSS was better in stage-IA vs. IB (p = 0.043). Late vaginal and bladder G3-complication rates were 2.1%, respectively.

    Conclusion Inoperable EC patients can be safely treated by BT with 2 and 5 year CSS of 93 and 80.5%, respectively, with even better results for IA cases. Prospective studies on 3D-IGBT are necessary to better analyse EC patient outcomes based on dose and treated volumes.