Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/217423
Title: Are 7.5Gy×2 fractions more efficient than 6Gy×3 in exclusive postoperative endometrial cancer brachytherapy? a clinical and dosimetrical analysis
Author: Noorian, Faegheh
Abellana Sangrà, Rosa Mari
Zhang, Yaowen
Herreros, Antonio
Baltrons, Clara
Lancellotta, Valentina
Tagliaferri, Luca
Sabater, Sebastià
Torne, Aureli
Rovirosa Casino, Angeles
Keywords: Braquiteràpia
Càncer d'endometri
Vagina
Cirurgia
Radioisotope brachytherapy
Endometrial cancer
Vagina
Surgery
Issue Date: 1-Dec-2023
Publisher: Elsevier B.V.
Abstract: 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.
Note: Reproducció del document publicat a: https://doi.org/10.1016/j.radonc.2023.109909
It is part of: Radiotherapy and Oncology, 2023, vol. 189
URI: https://hdl.handle.net/2445/217423
Related resource: https://doi.org/10.1016/j.radonc.2023.109909
ISSN: 0167-8140
Appears in Collections:Articles publicats en revistes (Fonaments Clínics)

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