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Vaginal-cuff control and toxicity results of a daily HDR brachytherapy schedule in endometrial cancer patients

  • I. Ríos [2] ; A. Rovirosa [2] ; C. Ascaso [1] ; I. Valduvieco [2] ; A. Herreros [2] ; L. Castilla [2] ; S. Sabater [3] ; K. Holub [2] ; J. Pahisa [2] ; A. Biete [2] ; M. Arenas [4]
    1. [1] Universitat de Barcelona

      Universitat de Barcelona

      Barcelona, España

    2. [2] Hospital Clinic Universitari Barcelona, España
    3. [3] Hospital General de Albacete, España
    4. [4] Hospital Sant Joan de Reus, España
  • Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 18, Nº. 9 (September 2016), 2016, págs. 925-930
  • Idioma: inglés
  • Texto completo no disponible (Saber más ...)
  • Resumen
    • Purpose To analyze the vaginal-cuff local control (VCC) and toxicity in postoperative endometrial carcinoma patients (EC) underwent high-dose-rate brachytherapy (HDR-BT) administered daily.

      Materials and methods 154 consecutive patients received postoperative HDR-BT for EC from January 2007 to September 2011. FIGO-staging I–IIIC2 patients were divided into two groups according to risk classification: Group 1 (94/154) included high-risk or advanced disease patients and Group 2 (60/154) included intermediate-risk EC patients. Group 1 underwent external beam irradiation (EBI) plus HDR-BT (2 fractions of 5 Gy) and Group 2 underwent HDR-BT alone (4 fractions of 5 Gy). Toxicity evaluation was done with RTOG scores for bladder and rectum, and the objective criteria of LENT–SOMA for vagina.

      Results With a median follow-up of 46.7 months (36.6–61 months) only two patients developed vaginal-cuff recurrence in Group 1 (2.1 %) and none in group 2 (0 %). Early toxicity in Group 1 appeared 5.3 % in rectum, 7.5 % in bladder (G1–G2) and 2.1 % in vagina (G1); late toxicity was present in 7.3 % in rectum (all G1–G2 but 1 G3) and in 27.7 % in vagina (all G1–G2 but one G4). In Group 2, 6.7 % developed acute G1–G2 bladder and 6.6 % acute vaginal (G1–G2) toxicity. No late rectal or bladder toxicity was observed; 21.7 % of G1–G2 presented late problems in vagina.

      Conclusions The present HDR-BT schedule of 2 fractions of 5 Gy after EBI and 4 fractions of 5 Gy administered daily showed excellent results in terms of VCC and toxicity.


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