Are 7.5 Gy×2 fractions more efficient than 6 Gy×3 in exclusive postoperative endometrial cancer brachytherapy? A clinical and dosimetrical analysis
Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved..
PURPOSE: To compare two vaginal brachytherapy (VBT) schedules in postoperative endometrial carcinoma (PEC) patients considering vaginal-cuff relapses (VCR), late toxicities, dosimetry analysis and vaginal dilator use.
MATERIAL AND METHODS: 110 PEC patients were treated with exclusive high-dose-rate VBT using two schedules. Group-1:44-patients received 6 Gy×3fractions (September-2011-April-2014); Group-2:66-patients were treated with 7.5 Gy×2fractions with a dose limit of equivalent total doses in 2-Gy fr (EQD2(α/β=3)) of 68 Gy in the most exposed 2 cm3 of clinical target volume (CTV) (July-2015-November-2021). The dose was prescribed at 5 mm from the applicator surface. Were evaluated the overall radiation dose delivered to 90% of the CTV (D90), the CTV receiving 100% of the prescription dose (V100) and the EQD2(α/β=3) received in the most exposed 2 cm3 to dose in CTV. Late toxicity was prospectively assessed using RTOG scores for bladder and rectum and objective LENT-SOMA criteria for late vaginal toxicity (LVT).
STATISTICS: Descriptive analysis, Chi-square, Student's t-tests and Kaplan and Meier method.
RESULTS: The median follow-up was 60 months (15.9-60). There were no VCR or late toxicities in bladder or rectum. LVT ≥ G1 appeared in 26/44 (59.1%) in Group-1 and 25/66 (37.9%) in Group-2. The mean EQD2(α/β=3) received by the most exposed 2 cm3 of CTV was 63.7 Gy ± 10.0 in Group-1 and 60.5 Gy ± 3.8 in Group-2 (p = 0.063). There were no differences in adherence to vaginal dilator use ≥9 months, overall D90 and V100.
CONCLUSION: Considering the lack of vaginal relapses and similar LVT over time, 7.5 Gy×2fractions seem more efficient in terms of patient comfort, workload, and cost. This is the first study using dosimetry parameters to compare effectivity of schedules. Larger series are needed to confirm the present results.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:189 |
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| Enthalten in: |
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology - 189(2023) vom: 01. Dez., Seite 109909 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Noorian, Faegheh [VerfasserIn] |
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| Links: |
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| Themen: |
Endometrial cancer |
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| Anmerkungen: |
Date Completed 28.11.2023 Date Revised 04.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.radonc.2023.109909 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361968124 |
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| 100 | 1 | |a Noorian, Faegheh |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Are 7.5 Gy×2 fractions more efficient than 6 Gy×3 in exclusive postoperative endometrial cancer brachytherapy? A clinical and dosimetrical analysis |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 28.11.2023 | ||
| 500 | |a Date Revised 04.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a PURPOSE: To compare two vaginal brachytherapy (VBT) schedules in postoperative endometrial carcinoma (PEC) patients considering vaginal-cuff relapses (VCR), late toxicities, dosimetry analysis and vaginal dilator use | ||
| 520 | |a MATERIAL AND METHODS: 110 PEC patients were treated with exclusive high-dose-rate VBT using two schedules. Group-1:44-patients received 6 Gy×3fractions (September-2011-April-2014); Group-2:66-patients were treated with 7.5 Gy×2fractions with a dose limit of equivalent total doses in 2-Gy fr (EQD2(α/β=3)) of 68 Gy in the most exposed 2 cm3 of clinical target volume (CTV) (July-2015-November-2021). The dose was prescribed at 5 mm from the applicator surface. Were evaluated the overall radiation dose delivered to 90% of the CTV (D90), the CTV receiving 100% of the prescription dose (V100) and the EQD2(α/β=3) received in the most exposed 2 cm3 to dose in CTV. Late toxicity was prospectively assessed using RTOG scores for bladder and rectum and objective LENT-SOMA criteria for late vaginal toxicity (LVT) | ||
| 520 | |a STATISTICS: Descriptive analysis, Chi-square, Student's t-tests and Kaplan and Meier method | ||
| 520 | |a RESULTS: The median follow-up was 60 months (15.9-60). There were no VCR or late toxicities in bladder or rectum. LVT ≥ G1 appeared in 26/44 (59.1%) in Group-1 and 25/66 (37.9%) in Group-2. The mean EQD2(α/β=3) received by the most exposed 2 cm3 of CTV was 63.7 Gy ± 10.0 in Group-1 and 60.5 Gy ± 3.8 in Group-2 (p = 0.063). There were no differences in adherence to vaginal dilator use ≥9 months, overall D90 and V100 | ||
| 520 | |a CONCLUSION: Considering the lack of vaginal relapses and similar LVT over time, 7.5 Gy×2fractions seem more efficient in terms of patient comfort, workload, and cost. This is the first study using dosimetry parameters to compare effectivity of schedules. Larger series are needed to confirm the present results | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Endometrial cancer | |
| 650 | 4 | |a Fractionation schedules | |
| 650 | 4 | |a Vaginal-cuff brachytherapy | |
| 700 | 1 | |a Abellana, Rosa |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Yaowen |e verfasserin |4 aut | |
| 700 | 1 | |a Herreros, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Baltrons, Clara |e verfasserin |4 aut | |
| 700 | 1 | |a Lancellota, Vallentina |e verfasserin |4 aut | |
| 700 | 1 | |a Tagliaferri, Luca |e verfasserin |4 aut | |
| 700 | 1 | |a Sabater, Sebastia |e verfasserin |4 aut | |
| 700 | 1 | |a Torne, Aureli |e verfasserin |4 aut | |
| 700 | 1 | |a Rovirosa, Angeles |e verfasserin |4 aut | |
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