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

Journal Article · Sat Oct 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.06.001· OSTI ID:21587734

Rovirosa, Angeles ^[1]; Ascaso, Carlos ^[2]; Sanchez-Reyes, Alberto ^[3]; Herreros, Antonio ^[1]; Abellana, Rosa ^[2]; Pahisa, Jaume; Lejarcegui, Jose Antonio ^[4]; Biete, Albert ^[1]

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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)

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.

• OSTI ID: 21587734
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 81, 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); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

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