eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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2/2020
vol. 12
 
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abstract:
Original paper

One-week vaginal brachytherapy schedule as exclusive adjuvant post-operative treatment in intermediate- and high-intermediate-risk endometrial cancer patients

Vitaliana De Sanctis
1
,
Daniela Musio
2
,
Francesca De Felice
3
,
Francesco Marampon
3
,
Maurizio Valeriani
1
,
Paolo Bonome
1
,
Dimitri Anzellini
1
,
Giuseppe Facondo
1
,
Gianluca Vullo
1
,
Maria Massaro
1
,
Mario Di Staso
4
,
Pierluigi Bonfili
5
,
Agnieszka Chalaszczyk
6
,
Giovanni Luca Gravina
6
,
Vincenzo Tombolini
3
,
Mattia Falchetto Osti
1

1.
Radiotherapy Oncology, Department of Medicine and Surgery and Translational Medicine, “Sapienza” University of Rome, S Andrea Hospital, Rome, Italy
2.
Radiotherapy Oncology, Policlinico Umberto I, Rome, Italy
3.
Department of Radiotherapy, “Sapienza” University of Rome, Policlinico Umberto I, Rome, Italy
4.
Radiotherapy Oncology, S Salvatore Hospital, L’Aquila, Italy
5.
Radiotherapy Oncology, Spirito Santo Hospital, Pescara, Italy
6.
Radiotherapy Oncology, University of L’Aquila, Italy
J Contemp Brachytherapy 2020; 12, 2: 124–130
Online publish date: 2020/04/30
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Purpose
The aim of the study was to report survival outcomes and toxicities incidence by using one-week vaginal brachytherapy (VBT) schedule in intermediate- and high-intermediate-risk endometrial cancer patients.

Material and methods
One hundred and eight patients were treated with exclusive high-dose-rate (HDR) brachytherapy short schedule (7 Gy/fraction/every other day/1 week). Acute and late rectal, urinary, and vaginal toxicities were recorded according to radiation therapy oncology group (RTOG) scores and late effects normal tissue task force – subjective, objective, management, analytic (LENT-SOMA) scores, respectively. Overall survival (OS), cause specific survival (CSS), and disease-free survival (DFS) were evaluated.

Results
Median follow-up was 44 months (range, 6-117 months). The 5-year OS, CSS, and DFS rates were 92.7%, 96.4%, and 89.5%, respectively. Seven of 108 (6.5%) patients relapsed after a median time of 31 months (range, 5-56 months). Death occurred in 6 patients. Four patients died for intercurrent causes without an evidence of disease. Acute bladder toxicity G1-G2 was reported in 11 of 108 (10%) patients, vaginal toxicity G1-G2 in 6 of 108 (5.5%), and gastrointestinal toxicity was observed in 3 of 108 (3%) patients. Late bladder and gastrointestinal G1 toxicities were reported in 4 of 108 (4%) and 1 of 108 (1%) patients, respectively. Late vaginal toxicity (G1-G2) was recorded in 3 of 108 (3%) cases. No grade 3-4 bladder, vaginal, and gastrointestinal toxicities were noted.

Conclusions
Exclusive short course adjuvant VBT is an effective treatment in patients with early-stage endometrial cancer and provides good outcomes in terms of disease local control and DFS, with low rates of toxicity profile.

keywords:

endometrial cancer, brachytherapy, vaginal vault, toxicity, survival, local recurrence

 
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