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Title: | Preliminary results of a vaginal constraint for reducing G2 late vaginal complications after postoperative brachytherapy in endometrial cancer: A proepective analysis |
Author: | Zhang, Yaowen Gómez, Gabriela Ascaso Terrén, Carlos Herreros Martínez, Antonio Fornes, Balbino Mases, Joel Rochera, J. Tagliaferri, L. Sabater, Sebastià Torné Bladé, Aureli Biete Solà, Albert Rovirosa, Ángeles |
Keywords: | Braquiteràpia Càncer d'endometri Radioisotope brachytherapy Endometrial cancer |
Issue Date: | 1-Dec-2021 |
Publisher: | Springer Verlag |
Abstract: | Purpose: To evaluate the preliminary results of the use of 68 Gy EQD2(α/β=3 Gy) as a dose limit to the lowest dose in the most exposed 2 cm3 of the vagina in order to reduce G2 late vaginal problems in postoperative endometrial carcinoma (EC). Methods: From November 2016 to October 2019, 69 postoperative EC patients receiving vaginal brachytherapy (VBT) ± external beam radiotherapy (EBRT) were prospectively analyzed. The median EBRT dose was 45 Gy (range: 44-50.4 Gy), 1.8-2 Gy/day, 5 fractions(Fr)/week. VBT was administered with the following schedule: 1Fr of 7 Gy after EBRT and 2 daily Fr × 7.5 Gy in exclusive VBT. The dose was prescribed at 0.5 cm from the applicator surface with an active length of 2.5 cm; 56 patients were treated with vaginal cylinders (49-3.5 cm, 6-3 cm, and 1-2.5 cm) and 13 with the colpostat technique. The overall VBT dose was adjusted to meet the vaginal restriction of < 68 Gy EQD2(α/β=3 Gy) at 2 cm3. Late toxicity was prospectively assessed using RTOG scores for bladder and rectum, and the objective LENT-SOMA criteria for vagina. Results: With a median follow-up of 31.0 months, no vaginal-cuff recurrences were found. Late toxicity: only 1G1(1.4%) rectal toxicity; 21G1(30.4%) and 3G2(4.3%) vaginal complications. Only one (1.4%) of 3 G2 manifested as vaginal shortening. Conclusions: In postoperative EC patients treated with VBT, only one developed G2 vaginal stenosis with the use of 68 Gy EQD2(α/β=3 Gy) as a dose constraint. These preliminary results seem to indicate the value of this dose limit for reducing G2 vaginal stenosis. Nonetheless, these findings should be confirmed in a larger number of patients with longer follow-up. Keywords: Brachytherapy; Postoperative endometrial cancer; Vaginal complications; Vaginal constraint. |
Note: | Reproducció del document publicat a: https://doi.org/10.1007/s12094-021-02737-z |
It is part of: | Clinical & Translational Oncology, 2021 |
URI: | http://hdl.handle.net/2445/183182 |
Related resource: | https://doi.org/10.1007/s12094-021-02737-z |
ISSN: | 1699-048X |
Appears in Collections: | Articles publicats en revistes (Fonaments Clínics) |
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