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Title: Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer

Abstract

Purpose: To evaluate the tolerability and toxicity of administering vaginal brachytherapy (VB) concurrently during chemotherapy compared with the sequential approach for patients with endometrial cancer. Methods and Materials: A retrospective analysis of 372 surgically staged patients with endometrial cancer American Joint Committee on Cancer 2009 stages I to IV treated with adjuvant postoperative radiation therapy (RT) at our institution from 2001 to 2012 was conducted. All patients received VB + external beam RT (EBRT) + 6 cycles of adjuvant carboplatin- and paclitaxel-based chemotherapy. The VB mean dose was 15.08 Gy (range, 15-20 Gy), with 3 to 4 weekly applications, and the EBRT mean dose was 45 Gy delivered with 3-dimensional or intensity modulated RT techniques. Hematologic, gastrointestinal (GI), and genitourinary (GU) toxicities were assessed by Common Toxicity Criteria (CTC) and compared between sequential and concurrent chemotherapy and VB schedules. Results: Among patients who received RT and adjuvant chemotherapy, 180 of 372 patients (48%) received RT sandwiched between cycles 3 and 4 of chemotherapy. A separate group of 192 patients (52%) were treated with VB during the first 3 cycles of chemotherapy, with a weekly application on nonchemotherapy days, and received the EBRT portion in a sandwiched fashion. Patients treated withmore » VB during chemotherapy had a decreased overall treatment time by 4 weeks (P<.001; 95% confidence interval: 3.99-4.02) and sustained no difference in CTC-graded acute hematologic, GI, or GU toxicities in comparison with the patients treated with VB and chemotherapy in a sequential manner (P>.05). CTC grade 3 or 4 hematologic, GI, and GU toxicities were zero. Conclusions: VB during chemotherapy is well tolerated, decreases overall treatment time, and does not render more toxicity than the sequential regimen.« less

Authors:
; ; ; ;  [1]; ; ;  [2]; ;  [1]
  1. Department of Radiation Oncology, Weill Cornell Medical College of Cornell University, New York, New York (United States)
  2. Division of Gynecological Oncology, Department of Obstetrics and Gynecology, Weill Cornell Medical College of Cornell University, New York, New York (United States)
Publication Date:
OSTI Identifier:
22267933
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 87; Journal Issue: 4; Other Information: Copyright (c) 2013 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; BRACHYTHERAPY; CHEMOTHERAPY; COMPARATIVE EVALUATIONS; GY RANGE 10-100; NEOPLASMS; PATIENTS; TOXICITY

Citation Formats

Nagar, Himanshu, Boothe, Dustin, Parikh, Amar, Yondorf, Menachem, Parashar, Bhupesh, Gupta, Divya, Holcomb, Kevin, Caputo, Thomas, Chao, K. S. Clifford, Nori, Dattatreyudu, and Wernicke, A. Gabriella, E-mail: gaw9006@med.cornell.edu. Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2013.08.014.
Nagar, Himanshu, Boothe, Dustin, Parikh, Amar, Yondorf, Menachem, Parashar, Bhupesh, Gupta, Divya, Holcomb, Kevin, Caputo, Thomas, Chao, K. S. Clifford, Nori, Dattatreyudu, & Wernicke, A. Gabriella, E-mail: gaw9006@med.cornell.edu. Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer. United States. https://doi.org/10.1016/J.IJROBP.2013.08.014
Nagar, Himanshu, Boothe, Dustin, Parikh, Amar, Yondorf, Menachem, Parashar, Bhupesh, Gupta, Divya, Holcomb, Kevin, Caputo, Thomas, Chao, K. S. Clifford, Nori, Dattatreyudu, and Wernicke, A. Gabriella, E-mail: gaw9006@med.cornell.edu. 2013. "Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer". United States. https://doi.org/10.1016/J.IJROBP.2013.08.014.
@article{osti_22267933,
title = {Administration of Concurrent Vaginal Brachytherapy During Chemotherapy for Treatment of Endometrial Cancer},
author = {Nagar, Himanshu and Boothe, Dustin and Parikh, Amar and Yondorf, Menachem and Parashar, Bhupesh and Gupta, Divya and Holcomb, Kevin and Caputo, Thomas and Chao, K. S. Clifford and Nori, Dattatreyudu and Wernicke, A. Gabriella, E-mail: gaw9006@med.cornell.edu},
abstractNote = {Purpose: To evaluate the tolerability and toxicity of administering vaginal brachytherapy (VB) concurrently during chemotherapy compared with the sequential approach for patients with endometrial cancer. Methods and Materials: A retrospective analysis of 372 surgically staged patients with endometrial cancer American Joint Committee on Cancer 2009 stages I to IV treated with adjuvant postoperative radiation therapy (RT) at our institution from 2001 to 2012 was conducted. All patients received VB + external beam RT (EBRT) + 6 cycles of adjuvant carboplatin- and paclitaxel-based chemotherapy. The VB mean dose was 15.08 Gy (range, 15-20 Gy), with 3 to 4 weekly applications, and the EBRT mean dose was 45 Gy delivered with 3-dimensional or intensity modulated RT techniques. Hematologic, gastrointestinal (GI), and genitourinary (GU) toxicities were assessed by Common Toxicity Criteria (CTC) and compared between sequential and concurrent chemotherapy and VB schedules. Results: Among patients who received RT and adjuvant chemotherapy, 180 of 372 patients (48%) received RT sandwiched between cycles 3 and 4 of chemotherapy. A separate group of 192 patients (52%) were treated with VB during the first 3 cycles of chemotherapy, with a weekly application on nonchemotherapy days, and received the EBRT portion in a sandwiched fashion. Patients treated with VB during chemotherapy had a decreased overall treatment time by 4 weeks (P<.001; 95% confidence interval: 3.99-4.02) and sustained no difference in CTC-graded acute hematologic, GI, or GU toxicities in comparison with the patients treated with VB and chemotherapy in a sequential manner (P>.05). CTC grade 3 or 4 hematologic, GI, and GU toxicities were zero. Conclusions: VB during chemotherapy is well tolerated, decreases overall treatment time, and does not render more toxicity than the sequential regimen.},
doi = {10.1016/J.IJROBP.2013.08.014},
url = {https://www.osti.gov/biblio/22267933}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 87,
place = {United States},
year = {Fri Nov 15 00:00:00 EST 2013},
month = {Fri Nov 15 00:00:00 EST 2013}
}