Vaginal brachytherapy for early stage uterine papillary serous and clear cell endometrial cancer

详细信息    查看全文

• 作者：Kanokpis Townamchai^a ; Ross Berkowitz^b ; Mandar Bhagwat^a ; Antonio L. Damato^a ; Scott Friesen^a ; Larissa J. Lee^a ; Ursula Matulonis^c ; Desmond O'Farrell^a ; Akila N. Viswanathan^a ; ^{aviswanathan@lroc.harvard.edu}
• 关键词：Vaginal brachytherapy ; Uterine papillary serous cancer ; High-dose-rate brachytherapy
• 刊名：Gynecologic Oncology
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：129
• 期：1
• 页码：18-21
• 全文大小：226 K

文摘

Objective

To report clinical outcomes following adjuvant high-dose-rate (HDR) vaginal brachytherapy (VB) for early-stage uterine papillary serous (UPSC) and clear cell (CC) endometrial cancer.

Methods

A retrospective study of Stage I and II papillary serous and clear cell endometrial cancer treated with post-operative HDR VB between October 2005 and May 2012 was performed. A total of 37 patients were identified, 26 with UPSC, 9 with CC and 2 with mixed UPSC/CC. After total hysterectomy and bilateral salpingo-oophorectomy, VB was administered without external-beam radiation with a dose of 24 Gy in 6 fractions prescribed to the vaginal surface. Chemotherapy was given to 30 patients (75 % ).

Results

The median follow up time was 24.8 months (range, 2.0 to 71.5 months). Four patients relapsed, 2 with UPSC and 2 with CC. The initial site of relapse was concurrent vagina, pelvic/para-aortic nodes and abdominal wall (1), pelvic/para-aortic nodes (1) and para-aortic nodes alone (2). The 2-year vaginal-control rate was 96.8 % . The pelvic-control rate including vaginal and nodal relapse was 93.5 % . The 2-year disease-free and overall survival rates were 89.3 % and 100 % , respectively.

Conclusion

HDR VB as the sole adjuvant treatment modality for early-stage UPSC/CC is associated with a low rate of vaginal relapse and excellent survival outcomes. This novel low-dose regimen for VB is safe and effective.