Is one brachytherapy fraction of 7 Gy similar to more fractions after external beam irradiation in postoperative endometrial carcinoma?

• Y. Zhang ^[2] ; C. Ascaso ^[1] ; A. Herreros ^[2] ; J. Sánchez ^[3] ; M. del Pino ^[4] ; A. Torné ^[4] ; Y. Li ^[2] ; S. Sabater ^[5] ; M. Arenas ^[6] ; A. Biete ^[2] ; Á. Rovirosa ^[2]
  1. [1] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  2. [2] Radiation Oncology Department, Hospital Clinic I Universitari, C/ Villarroel 170, 08036 Barcelona, Spain
  3. [3] Economics Department, Hospital Clinic I Universitari, Barcelona, Spain
  4. [4] Gynecological Cancer Unit, Gynecological and Obstetrics Department, Hospital Clinic I Universitari, Barcelona, Spain
  5. [5] Radiation Oncology Department, Hospital General Universitario de Albacete, Albacete, Spain
  6. [6] Radiation Oncology Department, Hospital San Joan de Reus, Reus, Spain

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 22, Nº. 8, 2020, págs. 1295-1302
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose To determine whether brachytherapy with a single hypofractionated dose of 7 Gy provides the similar vaginal-cuff relapses and safety profile in terms of complications compared to schedules of 2 or 3 fractions of lower doses in patients treated previously with external beam irradiation in postoperative endometrial carcinoma.

    Methods/material From June 2003 to December 2016, 325 patients were treated with 3 different schedules of high-dose- rate brachytherapy after external beam irradiation for postoperative endometrial carcinoma. The patients were divided into 3 groups: Group-1: 125 patients were treated with 3 fractions of 4–6 Gy per fraction (3 fractions/week) between 2003 and 2008; Group-2: 93 patients were treated with 2 consecutive daily fractions of 5–6 Gy between 2008 and 2011; Group-3: 107 patients received a single fraction of 7 Gy between 2011 and 2016. Bladder and rectum complications were assessed using RTOG scores and with the objective scores of LENT-SOMA for the vagina. Statistics: the chi-square test.

    Results The mean follow-up of Groups 1, 2 and 3 was 95, 67 and 51 months, respectively. Three patients in Group-1, 2 in Group-2, 1 in Group-3 developed vaginal-cuff relapse ( p = 0.68). No differences were found in late toxicity among the three groups.

    Conclusions One single dose of 7 Gy is safe and effective and may be the best treatment schedule with a similar incidence of vaginal-cuff relapses, complications and patient comfort with less hospital attendance.