ESTRO WORKING GROUP;
ADAPTIVE BRACHYTHERAPY;
RECOMMENDATIONS;
PARAMETERS;
CARCINOMA;
D O I:
10.1016/j.ygyno.2020.10.021
中图分类号:
R73 [肿瘤学];
学科分类号:
100214 ;
摘要:
Purpose/objectives. High dose rate (HDR) interstitial brachytherapy (ISBT) boost is integral for definitive radiation treatment of primary vaginal cancer. Technological advances with CT or MRI guidance provide improved precision and ability to treat more extensively invasive tumors over historical techniques, but reported experience is limited. We sought to provide updated outcome and toxicity data for women with primary vaginal cancer undergoing treatment with a modern ISBT technique. Material/methods. Databases of primary vaginal carcinoma patients treated at two Canadian academic cancer institutions were combined including patient, tumor and treatment characteristics, and survival outcomes and toxicity data. Descriptive statistics, survival estimates based on the Kaplan-Meier method, and univariable/multivariable Cox proportional hazards regression analyses are reported. Results. Between 2002 and 2017, 67 women with primary vaginal cancer were treated with 3D HDR ISBT. FIGO stage distribution was I (22.4%), II(50.8%), III(17.9%),IVa (9.0%). All patients received external beam radiotherapy and HDR ISBT of 500-750 cGy per fraction over 2-4 fractions. Median follow-up was 2.68 years (95% confidence interval: 2.04-6.04). Cumulative rate of grade 3-4 genitourinary/gastrointestinal toxicity was 10.4%. Four patients developed vaginal fistula Progression free survival at 2 and 3 years was 735% and 66.4% for all patients, 78.3% and 75.0% for stage I-II and 61.6% and 462% for stage III-IVa, respectively (log-rank p = 0252). Conclusions. Use of 3D image-guided HDR ISBT boost was safe and resulted in improved survival outcomes compared to historical rates in this series of primary vaginal cancer patients. Prospective study is warranted to better define clinical and dosimetric predictors of local control. (C) 2020 Elsevier Inc. All rights reserved.
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Manuel, Matthias M.
;
Cho, Linda P.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Cho, Linda P.
;
Catalano, Paul J.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Sch Publ Hlth, Dana Farber Canc Inst, Dept Biostat & Computat Biol, Boston, MA USA
Harvard Sch Publ Hlth, Dept Biostat, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Catalano, Paul J.
;
Damato, Antonio. L.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Damato, Antonio. L.
;
Miyamoto, David T.
论文数: 0引用数: 0
h-index: 0
机构:
Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Miyamoto, David T.
;
Tempany, Clare M.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Brigham & Womens Hosp, Dept Radiol, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Tempany, Clare M.
;
Schmidt, Ehud J.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Brigham & Womens Hosp, Dept Radiol, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Schmidt, Ehud J.
;
Viswanathan, Akila N.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Manuel, Matthias M.
;
Cho, Linda P.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Cho, Linda P.
;
Catalano, Paul J.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Sch Publ Hlth, Dana Farber Canc Inst, Dept Biostat & Computat Biol, Boston, MA USA
Harvard Sch Publ Hlth, Dept Biostat, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Catalano, Paul J.
;
Damato, Antonio. L.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Damato, Antonio. L.
;
Miyamoto, David T.
论文数: 0引用数: 0
h-index: 0
机构:
Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Miyamoto, David T.
;
Tempany, Clare M.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Brigham & Womens Hosp, Dept Radiol, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Tempany, Clare M.
;
Schmidt, Ehud J.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Brigham & Womens Hosp, Dept Radiol, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA
Schmidt, Ehud J.
;
Viswanathan, Akila N.
论文数: 0引用数: 0
h-index: 0
机构:
Harvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USAHarvard Med Sch, Dept Radiat Oncol, Brigham & Womens Hosp, Dana Farber Canc Inst, Boston, MA USA