Long-Term Survivors Using Intraoperative Radiotherapy for Recurrent Gynecologic Malignancies
Abstract
Purpose: To analyze the outcomes of therapy and identify prognostic factors for patients treated with surgery followed by intraoperative radiotherapy (IORT) for gynecologic malignancies at a single institution. Methods and Materials: We performed a retrospective review of 36 consecutive patients treated with IORT to 44 sites with mean follow-up of 50 months. The primary site was the cervix in 47%, endometrium in 31%, vulva in 14%, vagina in 6%, and fallopian tubes in 3%. Previous RT had failed in 72% of patients, and 89% had recurrent disease. Of 38 IORT sessions, 84% included maximal cytoreductive surgery, including 18% exenterations. The mean age was 52 years (range, 30-74), mean tumor size was 5 cm (range, 0.5-12), previous disease-free interval was 32 months (range, 0-177), and mean IORT dose was 1,152 cGy (range, 600-1,750). RT and systemic therapy after IORT were given to 53% and 24% of the cohort, respectively. The outcomes measured were locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS), and treatment-related complications. Results: The Kaplan-Meier 5-year LRC, DMFS, and DSS probability for the whole group was 44%, 51%, and 47%, respectively. For cervical cancer patients, the Kaplan-Meier 5-year LRC, DMFS, and DSS estimate was 45%, 60%, andmore »
- Authors:
-
- Department of Radiation Oncology, Stanford Cancer Center, Stanford, CA (United States)
- Department of Health Research and Policy, Stanford University Medical Center, Stanford, CA (United States)
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Stanford University Medical Center, Stanford, CA (United States)
- Publication Date:
- OSTI Identifier:
- 21036254
- Resource Type:
- Journal Article
- Journal Name:
- International Journal of Radiation Oncology, Biology and Physics
- Additional Journal Information:
- Journal Volume: 69; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2007.03.021; PII: S0360-3016(07)00517-2; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
- Subject:
- 62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; METASTASES; MULTIVARIATE ANALYSIS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; SURGERY; UTERUS
Citation Formats
Tran, Phuoc T, Zheng, Su, Hara, Wendy, Husain, Amreen, Teng, Nelson, and Kapp, Daniel S. Long-Term Survivors Using Intraoperative Radiotherapy for Recurrent Gynecologic Malignancies. United States: N. p., 2007.
Web. doi:10.1016/j.ijrobp.2007.03.021.
Tran, Phuoc T, Zheng, Su, Hara, Wendy, Husain, Amreen, Teng, Nelson, & Kapp, Daniel S. Long-Term Survivors Using Intraoperative Radiotherapy for Recurrent Gynecologic Malignancies. United States. https://doi.org/10.1016/j.ijrobp.2007.03.021
Tran, Phuoc T, Zheng, Su, Hara, Wendy, Husain, Amreen, Teng, Nelson, and Kapp, Daniel S. 2007.
"Long-Term Survivors Using Intraoperative Radiotherapy for Recurrent Gynecologic Malignancies". United States. https://doi.org/10.1016/j.ijrobp.2007.03.021.
@article{osti_21036254,
title = {Long-Term Survivors Using Intraoperative Radiotherapy for Recurrent Gynecologic Malignancies},
author = {Tran, Phuoc T and Zheng, Su and Hara, Wendy and Husain, Amreen and Teng, Nelson and Kapp, Daniel S.},
abstractNote = {Purpose: To analyze the outcomes of therapy and identify prognostic factors for patients treated with surgery followed by intraoperative radiotherapy (IORT) for gynecologic malignancies at a single institution. Methods and Materials: We performed a retrospective review of 36 consecutive patients treated with IORT to 44 sites with mean follow-up of 50 months. The primary site was the cervix in 47%, endometrium in 31%, vulva in 14%, vagina in 6%, and fallopian tubes in 3%. Previous RT had failed in 72% of patients, and 89% had recurrent disease. Of 38 IORT sessions, 84% included maximal cytoreductive surgery, including 18% exenterations. The mean age was 52 years (range, 30-74), mean tumor size was 5 cm (range, 0.5-12), previous disease-free interval was 32 months (range, 0-177), and mean IORT dose was 1,152 cGy (range, 600-1,750). RT and systemic therapy after IORT were given to 53% and 24% of the cohort, respectively. The outcomes measured were locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS), and treatment-related complications. Results: The Kaplan-Meier 5-year LRC, DMFS, and DSS probability for the whole group was 44%, 51%, and 47%, respectively. For cervical cancer patients, the Kaplan-Meier 5-year LRC, DMFS, and DSS estimate was 45%, 60%, and 46%, respectively. The prognostic factors found on multivariate analysis (p {<=} 0.05) were the disease-free interval for LRC, tumor size for DMFS, and cervical primary, previous surgery, and locoregional relapse for DSS. Our cohort had 10 Grade 3-4 complications associated with treatment (surgery and IORT) and a Kaplan-Meier 5-year Grade 3-4 complication-free survival rate of 72%. Conclusions: Survival for pelvic recurrence of gynecologic cancer is poor (range, 0-25%). IORT after surgery seems to confer long-term local control in carefully selected patients.},
doi = {10.1016/j.ijrobp.2007.03.021},
url = {https://www.osti.gov/biblio/21036254},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 69,
place = {United States},
year = {Mon Oct 01 00:00:00 EDT 2007},
month = {Mon Oct 01 00:00:00 EDT 2007}
}