Adjuvant vaginal cuff brachytherapy for high-risk, early stage endometrial cancer.
Publication/Presentation Date
10-1-2014
Abstract
PURPOSE: To report outcomes following adjuvant high-dose-rate vaginal brachytherapy (VBT) with or without chemotherapy for high-intermediate risk (HIR) and high-risk, early stage endometrial cancer as defined in Gynecologic Oncology Group trial 0249.
MATERIAL AND METHODS: From May 2000 to January 2014, 68 women with HIR and high-risk endometrial cancer underwent surgical staging followed by VBT. Median VBT dose was 21 Gy delivered in three fractions prescribed to 0.5 cm depth. Paclitaxel 175 mg/m(2) and carboplatin area under the curve 6 was administered every 21 days in sequence with VBT. Actuarial survival estimates were calculated using the Kaplan-Meier method.
RESULTS: Patient demographics included a median age of 66 years (range: 36-91) and stages IA (49%), IB (38%), and II (13%), respectively. Thirty-one (46%) patients had HIR disease with endometrioid histology, and 33 (48%) patients had serous or clear cell histology. Thirty-seven (54%) patients received a median 3 cycles (range: 3-6) of chemotherapy in addition to VBT, and 65 patients (96%) completed all prescribed therapy. During a median follow up of 33.1 months (range: 4.0-161.7), four patients have recurred, including one vaginal recurrence. The 3-year estimates of vaginal, pelvic, and distant recurrences were 1.9%, 2.4%, and 9.1%, respectively. The 3-year rates of disease-free and overall survival were 87.7% and 93.9%, respectively.
CONCLUSIONS: Early outcomes with adjuvant VBT with or without chemotherapy demonstrate high rates of vaginal and pelvic control for women with HIR disease. Early vaginal and pelvic relapses in high-risk patients suggest that pelvic external beam radiotherapy is warranted in this subgroup, but additional data from large phase III trials is warranted.
Volume
6
Issue
3
First Page
262
Last Page
270
ISSN
1689-832X
Published In/Presented At
Eldredge-Hindy, H. B., Eastwick, G., Anne, P. R., Rosenblum, N. G., Schilder, R. J., Chalian, R., Zibelli, A. M., Kim, C. H., & Den, R. (2014). Adjuvant vaginal cuff brachytherapy for high-risk, early stage endometrial cancer. Journal of contemporary brachytherapy, 6(3), 262–270. https://doi.org/10.5114/jcb.2014.45031
Disciplines
Medicine and Health Sciences
PubMedID
25337127
Department(s)
Department of Obstetrics and Gynecology
Document Type
Article