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. 2015 Apr;7(2):122-7.
doi: 10.5114/jcb.2015.50877. Epub 2015 Apr 20.

The impact of a vaginal brachytherapy boost to pelvic radiation in stage III endometrial cancer

Adam Huddleston  1 , Sally Zhen  1 , Lihong Qi  2 , Dominique Rash  1 , Gary Leiserowitz  3 , Jyoti Mayadev  1
Affiliations

The impact of a vaginal brachytherapy boost to pelvic radiation in stage III endometrial cancer

Adam Huddleston et al. J Contemp Brachytherapy. 2015 Apr.

Abstract

Purpose: We investigate the use and impact of a vaginal brachytherapy boost (VBB) after pelvic radiotherapy for stage III endometrial adenocarcinoma on vaginal and pelvic control.

Material and methods: One hundred patients treated from 1998-2011 with surgery and adjuvant therapy with or without a VBB were included. Variables examined were grade, stage, lymphovascular space invasion (LVSI), vaginal involvement (VI), cervical stromal involvement (CSI), myometrial invasion (MI), and a VBB. Failure was scored as vaginal, or pelvic. Fisher's exact test assessed association between variables with vaginal and pelvic control.

Results: With a median follow up of 43 months, 31% were stage IIIA, 6% stage IIIB, and 63% stage IIIC. Thirty-eight (38%) received pelvic radiotherapy alone, and 62% received adjuvant chemotherapy. Of the 100 patients, 82 were treated with a VBB, 10 were not treated with a VBB, and 8 were not treated with RT. Of the 82 patients who received a VBB, 5 failed in the vagina with vaginal and pelvic control rates of 94% and 92%. The impact of VB reached borderline significance with its impact on pelvic control, 92% vs. 70% (p = 0.056), and did not affect vaginal control, 94% and 90% (p = 0.50). Neither tumor grade, LVSI, CSI, stage, nor LVSI (p > 0.05) statistically significantly impacted vaginal control.

Conclusions: There are no clinical guidelines for the use of a VBB in stage III endometrial cancer. The majority of our patients were treated with a VBB and experienced excellent pelvic and vaginal control. The presence of traditional adverse features did not negatively impact control in our patient cohort. However, the role of a VBB needs further investigation to understand the incremental benefit beyond pelvic RT.

Keywords: endometrial cancer; pelvic radiation therapy; vaginal brachytherapy.

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Figures

Fig. 1
Fig. 1
Image verification of a vaginal brachytherapy implantation
See this image and copyright information in PMC

References

    1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012;62:10–29. - PubMed
    1. Hogberg T, Signorelli M, de Oliveira CF, et al. Sequential adjuvant chemotherapy and radiotherapy in endometrial cancer – results from two randomised studies. Eur J Cancer. 2010;46:2422–2431. - PMC - PubMed
    1. Lee LJ, Viswanathan AN. Combined chemotherapy and radiation improves survival for node-positive endometrial cancer. Gynecol Oncol. 2012;127:32–37. - PMC - PubMed
    1. Nelson G, Randall M, Sutton G, et al. FIGO stage IIIC endometrial carcinoma with metastases confined to pelvic lymph nodes: analysis of treatment outcomes, prognostic variables, and failure patterns following adjuvant radiation therapy. Gynecol Oncol. 1999;75:211–214. - PubMed
    1. Schorge JO, Molpus KL, Goodman A, et al. The effect of postsurgical therapy on stage III endometrial carcinoma. Gynecol Oncol. 1996;63:34–39. - PubMed