The impact of a vaginal brachytherapy boost to pelvic radiation in stage III endometrial cancer

被引:15
|
作者
Huddleston, Adam [1 ]
Zhen, Sally [1 ]
Qi, Lihong [2 ]
Rash, Dominique [1 ]
Leiserowitz, Gary [3 ]
Mayadev, Jyoti [1 ]
机构
[1] Univ Calif Davis, Dept Radiat Oncol, UC Davis Canc Ctr, Sacramento, CA 95817 USA
[2] Univ Calif Davis, Dept Publ Hlth Sci, Div Biostat, Sacramento, CA 95817 USA
[3] Univ Calif Davis, Dept Gynecol Oncol, Sacramento, CA 95817 USA
关键词
endometrial cancer; pelvic radiation therapy; vaginal brachytherapy; ADJUVANT CHEMOTHERAPY; THERAPY; CARCINOMA; SURVIVAL; SURGERY;
D O I
10.5114/jcb.2015.50877
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: We investigate the use and impact of a vaginal brachytherapy boost (VBB) after pelvic radiotherapy for stage III endometrial adenocarcinoma on vaginal and pelvic control. Material and methods: One hundred patients treated from 1998-2011 with surgery and adjuvant therapy with or without a VBB were included. Variables examined were grade, stage, lymphovascular space invasion (LVSI), vaginal involvement (VI), cervical stromal involvement (CSI), myometrial invasion (MI), and a VBB. Failure was scored as vaginal, or pelvic. Fisher's exact test assessed association between variables with vaginal and pelvic control. Results: With a median follow up of 43 months, 31% were stage IIIA, 6% stage IIIB, and 63% stage IIIC. Thirty-eight (38%) received pelvic radiotherapy alone, and 62% received adjuvant chemotherapy. Of the 100 patients, 82 were treated with a VBB, 10 were not treated with a VBB, and 8 were not treated with RT. Of the 82 patients who received a VBB, 5 failed in the vagina with vaginal and pelvic control rates of 94% and 92%. The impact of VB reached borderline significance with its impact on pelvic control, 92% vs. 70% (p = 0.056), and did not affect vaginal control, 94% and 90% (p = 0.50). Neither tumor grade, LVSI, CSI, stage, nor LVSI (p > 0.05) statistically significantly impacted vaginal control. Conclusions: There are no clinical guidelines for the use of a VBB in stage III endometrial cancer. The majority of our patients were treated with a VBB and experienced excellent pelvic and vaginal control. The presence of traditional adverse features did not negatively impact control in our patient cohort. However, the role of a VBB needs further investigation to understand the incremental benefit beyond pelvic RT.
引用
收藏
页码:122 / 127
页数:6
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