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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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Interview with Professor Janusz Skowronek
ABS 2015
4/2018
vol. 10
 
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abstract:
Original paper

EROS study: evaluation between high-dose-rate and low-dose-rate vaginal interventional radiotherapy (brachytherapy) in terms of overall survival and rate of stenosis

Rosa Autorino, Luca Tagliaferri, Maura Campitelli, Daniela Smaniotto, Alessia Nardangeli, Gian Carlo Mattiucci, Gabriella Macchia, Benedetta Gui, Maura Miccò, Floriana Mascilini, Gabriella Ferrandina, Gyorgy Kovacs, Vincenzo Valentini, Maria Antonietta Gambacorta

J Contemp Brachytherapy 2018; 10, 4: 315–320
Online publish date: 2018/08/31
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Purpose
To compare the survival and toxicity outcomes in patients with endometrial cancer treated with either high-dose-rate (HDR) or low-dose-rate (LDR) vaginal brachytherapy (VBT) following external beam radiotherapy (EBRT).

Material and methods
From January 2000 to December 2014, patients with endometrial cancer after radical hysterectomy with/without pelvic and/or para-aortic lymphadenectomy were treated with adjuvant EBRT (45 Gy, 1.8 Gy/day to the whole pelvis) and subsequent VBT boost (HDR dose of 7 Gy in one fraction or LDR VBT dose of 25 Gy). The dose was prescribed at 0.5 cm from the surface of the applicator and the proximal half to two-thirds of the vagina was irradiated. The outcomes of patients were evaluated in terms of local control (LC), overall survival (OS), and rates of adverse events.

Results
We analyzed data of 200 patients treated with EBRT followed by HDR VBT boost in 78 patients and LDR VBT boost in 122 patients. With a median follow-up of 25 months (range, 6-163), 5-year OS was 98% and 97% in the LDR and HDR groups, respectively (p = 0.37). The 5-year LC was similar (93% in both groups) (p = 0.81). In multivariate analyses, none of the factors assessed (age, stage, grade) impacted OS (p = 0.37) or LC (p = 0.81). Patients treated with LDR VBT after EBRT had higher rates of acute gastrointestinal toxicity. No differences were found in acute genitourinary or hematological toxicities. Late toxicity such as vaginal stenosis was registered during regular follow-up visits and was similar in the two groups (p = 0.67).

Conclusions
In our analysis, there were no differences in terms of OS and late toxicity outcomes for patients receiving LDR or HDR VBT. HDR VBT is a safe technique in comparison to LDR VBT.

keywords:

brachytherapy, endometrial cancer, interventional radiotherapy, vaginal stenosis

references:
American Cancer Society (US). What are the key statistics about endometrial cancer? [Internet]. Atlanta (GA): American Cancer Society, Inc. Available from http://www.cancer.org/cancer/endometrialcancer/detailedguide/endometrial – Uterine-Cancer-Key-Statistics; 2014 (updated 2014 Feb 3; cited 2014 Aug 23).
Creasman WT, Morrow CP, Bundy BN et al. Surgical pathologic spread patterns of endometrial cancer. A Gynecologic Oncology Group Study. Cancer 1987; 60: 2035-2041.
Creutzberg CL, van Putten WL, Koper PC et al. Surgery and postoperative radiotherapy versus surgery alone for patients with stage-1 endometrial carcinoma: multicentre randomised trial. Post-operative radiation therapy in endometrial carcinoma. Lancet 2000; 355: 1404-1411.
Keys HM, Roberts JA, Brunetto VL et al. A phase III trial of surgery with or without adjunctive external pelvic radiation therapy in intermediate risk endometrial adenocarcinoma: A Gynecologic Oncology Group study. Gynecol Oncol 2004; 92: 744-751.
Draghini L, Maranzano L, Casale M et al. Definitive three-dimensional high-dose-rate brachytherapy for inoperable endometrial cancer. J Contemp Brachytherapy 2017; 9: 118-123.
Podczaski E, Kaminski P, Gurski K et al. Detection and patterns of treatment failure in 300 consecutive cases of “early” endometrial cancer after primary surgery. Gynecol Oncol 1992; 47: 323-327.
Bergmark K, Avall-Lundqvist E, Dickman PW et al. Patient- rating of distressful symptoms after treatment for early cervical cancer. Acta Ostetr Gynecol Scand 2002; 81: 443-450.
Valentini V, Maurizi F, Tagliaferri L et al. Spider: managing clinical data of cancer patients treated through a multidisciplinary approach by a palm-based system. Ital J Public Health JPH 2008; 6.
Tagliaferri L, Kovács G, Autorino R et al. ENT COBRA (Consortium for Brachytherapy Data Analysis): interdisciplinary standardized data collection system for head and neck patients treated with interventional radiotherapy (brachytherapy). J Contemp Brachytherapy 2016; 8: 336-343.
Capirci C, Polico C, Mandoliti G. Dislocation of small bowel volume within box pelvic treatment fields, using new “up down table” device. Int J Radiat Oncol Biol Phys 2001; 51: 465-473.
https://www.rtog.org/ResearchAssociates/AdverseEventReporting/RTOGEORTCLateRadiationMorbidityScoringSchema.aspx
Nout RA, Putter H, Jürgenliemk-Schulz IM et al. Five-year quality of life of endometrial cancer patients treated in the randomised Postoperative Radiation Therapy in Endometrial Cancer (PORTEC-2) trial and comparison with norm data. Eur J Cancer 2012; 48: 1638-1648.
De Boer SM, Nout RA, Jürgenliemk-Schulz IM et al. Long-Term Impact of Endometrial Cancer Diagnosis and Treatment on Health-Related Quality of Life and Cancer Survivorship: Results from the Randomized PORTEC-2 Trial. Int J Radiat Oncol Biol Phys 2015; 93: 797-809.
Bekerus M, Durbaba M, Frim O et al. Comparison of HDR and LDR results in endometrium cancer. Sonderb Strahlenther Onkol 1988; 82: 222-227.
Rauthe G, Vahrson H, Giers G. Five-year results and complications in endometrium cancer: HDR afterloading vs. conventional radium therapy. Sonderb Strahlenther Onkol 1988; 82: 240-245.
Fayed A, Mutch DG, Rader JS et al. Comparison of high-dose-rate and low-dose-rate brachytherapy in the treatment of endometrial carcinoma. Int J Radiat Oncol Biol Phys 2007; 67: 480-484.
 
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