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Clinical and Translational Oncology

, Volume 18, Issue 9, pp 925–930 | Cite as

Vaginal-cuff control and toxicity results of a daily HDR brachytherapy schedule in endometrial cancer patients

  • I. RíosEmail author
  • A. Rovirosa
  • C. Ascaso
  • I. Valduvieco
  • A. Herreros
  • L. Castilla
  • S. Sabater
  • K. Holub
  • J. Pahisa
  • A. Biete
  • M. Arenas
Research Article

Abstract

Purpose

To analyze the vaginal-cuff local control (VCC) and toxicity in postoperative endometrial carcinoma patients (EC) underwent high-dose-rate brachytherapy (HDR-BT) administered daily.

Materials and methods

154 consecutive patients received postoperative HDR-BT for EC from January 2007 to September 2011. FIGO-staging I–IIIC2 patients were divided into two groups according to risk classification: Group 1 (94/154) included high-risk or advanced disease patients and Group 2 (60/154) included intermediate-risk EC patients. Group 1 underwent external beam irradiation (EBI) plus HDR-BT (2 fractions of 5 Gy) and Group 2 underwent HDR-BT alone (4 fractions of 5 Gy). Toxicity evaluation was done with RTOG scores for bladder and rectum, and the objective criteria of LENT–SOMA for vagina.

Results

With a median follow-up of 46.7 months (36.6–61 months) only two patients developed vaginal-cuff recurrence in Group 1 (2.1 %) and none in group 2 (0 %). Early toxicity in Group 1 appeared 5.3 % in rectum, 7.5 % in bladder (G1–G2) and 2.1 % in vagina (G1); late toxicity was present in 7.3 % in rectum (all G1–G2 but 1 G3) and in 27.7 % in vagina (all G1–G2 but one G4). In Group 2, 6.7 % developed acute G1–G2 bladder and 6.6 % acute vaginal (G1–G2) toxicity. No late rectal or bladder toxicity was observed; 21.7 % of G1–G2 presented late problems in vagina.

Conclusions

The present HDR-BT schedule of 2 fractions of 5 Gy after EBI and 4 fractions of 5 Gy administered daily showed excellent results in terms of VCC and toxicity.

Keywords

Endometrial cancer Gynecologic brachytherapy Brachytherapy schedules Endometrial cancer adjuvant treatment 

Notes

Acknowledgments

Grant AECC Scientific Foundation. This work was presented, in part, at the 33th ESTROFORUM Meeting. Barcelona 2015.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2015

Authors and Affiliations

  • I. Ríos
    • 1
    • 2
    Email author
  • A. Rovirosa
    • 1
  • C. Ascaso
    • 3
  • I. Valduvieco
    • 1
  • A. Herreros
    • 1
  • L. Castilla
    • 1
  • S. Sabater
    • 5
  • K. Holub
    • 1
  • J. Pahisa
    • 6
  • A. Biete
    • 1
  • M. Arenas
    • 4
  1. 1.Radiation Oncology Department, ICMHO, Functional Gynecologic Cancer UnitHospital Clinic UniversitariBarcelonaSpain
  2. 2.Radiation Oncology Department, Cancer InstituteCentro Medico ImbanacoCaliColombia
  3. 3.Public and Health Department, Medicine FacultyUniversitat de BarcelonaBarcelonaSpain
  4. 4.Radiation Oncology DepartmentHospital Sant Joan de ReusTarragonaSpain
  5. 5.Radiation Oncology DepartmentHospital General de AlbaceteAlbaceteSpain
  6. 6.Gynecological Surgery, Functional Gynecologic Cancer UnitHospital Clinic I UniversitariBarcelonaSpain

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