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Title: Three or Four Fractions of 4-5 Gy per Week in Postoperative High-Dose-Rate Brachytherapy for Endometrial Carcinoma

Abstract

Purpose: To evaluate the results of high-dose-rate brachytherapy (HDRBT) using a schedule of three or four fractions per week, when possible, in 89 patients on local control and toxicity in postoperative treatment of endometrial carcinoma. The effect of the overall HDRBT treatment time (OTT) on toxicity was also evaluated. Patients and Methods: Federation Internationale de Gynecologie Obstetrique Stage: 24 IB, 45 IC, 4 IIA, 6 IIB, 4 IIIA, 2 IIIB, and 4 IIIC. Radiotherapy: Group 1-67 of 89 patients received external beam irradiation (EBI; 44-50 Gy) plus HDRBT (3 fractions of 4-6 Gy); Group 2-22 of 89 patients received HDRBT alone (6 fractions of 4-5 Gy). OTT: Group 1-HDRBT was completed in a median of 5 days in 32 patients and in >5 days in 35; Group 2-HDRBT was completed in <15 days in 11 patients and in {>=}16 days in 11. Toxicity was evaluated using Radiation Therapy Oncology Group scores and the bioequivalent dose (BED) study was performed in vaginal mucosa surface. Statistics included Student's t test, chi-square test, and receiving operator curves. Results: With a mean follow-up of 31 months (range, 6-70), 1 of 89 patients had vaginal relapse. Early toxicity appeared in 8 of 89 (9%) patientsmore » and was resolved. Late toxicity appeared in 13/89 (14%): vaginal nine Grade 1, three Grade 2, one Grade 4; bladder two Grade 2; rectal three Grade 1, one Grade 2. No differences were found in relation to OTT in Groups 1 and 2. Mean BED was 88.48 Gy in Group 1 and 165.28 Gy in Group 2. Cases with Grade 2 late vaginal toxicity received >75 Gy after EBI and >165 Gy in Group 2. Conclusions: Three fractions of 4-5 Gy in 3-5 days after EBI or 6 fractions in <15 days in patients receiving HDRBT alone was a safe treatment in relation to toxicity and local control. Vaginal surface BED less than 75 Gy after EBI and less than 160 Gy in HDRBT alone may be safe to avoid G2 toxicity.« less

Authors:
 [1];  [2];  [3];  [1];  [2]; ;  [4];  [1]
  1. Radiation Oncology Department, Hospital Clinic, Institut d'Investicacio Biomedica Agusti Pi i Sunyer, Barcelona (Spain)
  2. Public Health Department, University of Barcelona, IDIBAPS (Spain)
  3. Radiation Oncology Department, Hospital Plato, Barcelona (Spain)
  4. Gynecology and Obstetrics Department, Hospital Clinic, Barcelona (Spain)
Publication Date:
OSTI Identifier:
21587734
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 81; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2010.06.001; PII: S0360-3016(10)00783-2; Copyright (c) 2011 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; BLADDER; BRACHYTHERAPY; CARCINOMAS; DOSE RATES; MUCOUS MEMBRANES; RADIATION DOSES; RECTUM; TOXICITY; BODY; DIGESTIVE SYSTEM; DISEASES; DOSES; GASTROINTESTINAL TRACT; INTESTINES; LARGE INTESTINE; MEDICINE; MEMBRANES; NEOPLASMS; NUCLEAR MEDICINE; ORGANS; RADIOLOGY; RADIOTHERAPY; THERAPY; URINARY TRACT

Citation Formats

Rovirosa, Angeles, E-mail: rovirosa@clinic.ub.es, Ascaso, Carlos, Sanchez-Reyes, Alberto, Herreros, Antonio, Abellana, Rosa, Pahisa, Jaume, Lejarcegui, Jose Antonio, and Biete, Albert. Three or Four Fractions of 4-5 Gy per Week in Postoperative High-Dose-Rate Brachytherapy for Endometrial Carcinoma. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2010.06.001.
Rovirosa, Angeles, E-mail: rovirosa@clinic.ub.es, Ascaso, Carlos, Sanchez-Reyes, Alberto, Herreros, Antonio, Abellana, Rosa, Pahisa, Jaume, Lejarcegui, Jose Antonio, & Biete, Albert. Three or Four Fractions of 4-5 Gy per Week in Postoperative High-Dose-Rate Brachytherapy for Endometrial Carcinoma. United States. doi:10.1016/j.ijrobp.2010.06.001.
Rovirosa, Angeles, E-mail: rovirosa@clinic.ub.es, Ascaso, Carlos, Sanchez-Reyes, Alberto, Herreros, Antonio, Abellana, Rosa, Pahisa, Jaume, Lejarcegui, Jose Antonio, and Biete, Albert. Sat . "Three or Four Fractions of 4-5 Gy per Week in Postoperative High-Dose-Rate Brachytherapy for Endometrial Carcinoma". United States. doi:10.1016/j.ijrobp.2010.06.001.
@article{osti_21587734,
title = {Three or Four Fractions of 4-5 Gy per Week in Postoperative High-Dose-Rate Brachytherapy for Endometrial Carcinoma},
author = {Rovirosa, Angeles, E-mail: rovirosa@clinic.ub.es and Ascaso, Carlos and Sanchez-Reyes, Alberto and Herreros, Antonio and Abellana, Rosa and Pahisa, Jaume and Lejarcegui, Jose Antonio and Biete, Albert},
abstractNote = {Purpose: To evaluate the results of high-dose-rate brachytherapy (HDRBT) using a schedule of three or four fractions per week, when possible, in 89 patients on local control and toxicity in postoperative treatment of endometrial carcinoma. The effect of the overall HDRBT treatment time (OTT) on toxicity was also evaluated. Patients and Methods: Federation Internationale de Gynecologie Obstetrique Stage: 24 IB, 45 IC, 4 IIA, 6 IIB, 4 IIIA, 2 IIIB, and 4 IIIC. Radiotherapy: Group 1-67 of 89 patients received external beam irradiation (EBI; 44-50 Gy) plus HDRBT (3 fractions of 4-6 Gy); Group 2-22 of 89 patients received HDRBT alone (6 fractions of 4-5 Gy). OTT: Group 1-HDRBT was completed in a median of 5 days in 32 patients and in >5 days in 35; Group 2-HDRBT was completed in <15 days in 11 patients and in {>=}16 days in 11. Toxicity was evaluated using Radiation Therapy Oncology Group scores and the bioequivalent dose (BED) study was performed in vaginal mucosa surface. Statistics included Student's t test, chi-square test, and receiving operator curves. Results: With a mean follow-up of 31 months (range, 6-70), 1 of 89 patients had vaginal relapse. Early toxicity appeared in 8 of 89 (9%) patients and was resolved. Late toxicity appeared in 13/89 (14%): vaginal nine Grade 1, three Grade 2, one Grade 4; bladder two Grade 2; rectal three Grade 1, one Grade 2. No differences were found in relation to OTT in Groups 1 and 2. Mean BED was 88.48 Gy in Group 1 and 165.28 Gy in Group 2. Cases with Grade 2 late vaginal toxicity received >75 Gy after EBI and >165 Gy in Group 2. Conclusions: Three fractions of 4-5 Gy in 3-5 days after EBI or 6 fractions in <15 days in patients receiving HDRBT alone was a safe treatment in relation to toxicity and local control. Vaginal surface BED less than 75 Gy after EBI and less than 160 Gy in HDRBT alone may be safe to avoid G2 toxicity.},
doi = {10.1016/j.ijrobp.2010.06.001},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 81,
place = {United States},
year = {2011},
month = {10}
}