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High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina

PURPOSE: The purpose of this study was to evaluate the efficacy of HDR brachytherapy for primary or recurrent vaginal cancer. METHODS: Between the years 2000 to 2006, 18 patients with primary or recurrent vaginal cancer were treated with brachytherapy (HDRB). Six patients had primary vaginal cancer...

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Autores principales: Beriwal, Sushil, Heron, Dwight E, Mogus, Robert, Edwards, Robert P, Kelley, Joseph L, Sukumvanich, Paniti
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2270281/
https://www.ncbi.nlm.nih.gov/pubmed/18271958
http://dx.doi.org/10.1186/1748-717X-3-7
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author Beriwal, Sushil
Heron, Dwight E
Mogus, Robert
Edwards, Robert P
Kelley, Joseph L
Sukumvanich, Paniti
author_facet Beriwal, Sushil
Heron, Dwight E
Mogus, Robert
Edwards, Robert P
Kelley, Joseph L
Sukumvanich, Paniti
author_sort Beriwal, Sushil
collection PubMed
description PURPOSE: The purpose of this study was to evaluate the efficacy of HDR brachytherapy for primary or recurrent vaginal cancer. METHODS: Between the years 2000 to 2006, 18 patients with primary or recurrent vaginal cancer were treated with brachytherapy (HDRB). Six patients had primary vaginal cancer (stage II to IVA) while 12 were treated for isolated vaginal recurrence (primary cervix = 4, vulva = 1 and endometrium = 7). Five patients had previous pelvic radiation therapy. All except one patient received external beam radiation therapy to a median dose of 45 Gy (range 31.2–55.8 Gy). The HDRB was intracavitary using a vaginal cylinder in 5 patients and interstitial using a modified Syed-Nesblett template in 13 patients. The dose of interstitial brachytherapy was 18.75 Gy in 5 fractions delivered twice daily. The median follow-up was 18 months (range 6–66 months). RESULTS: Complete response (CR) was achieved in all but one patient (94%). Of these 17 patients achieving a CR, 1 had local recurrence and 3 had systemic recurrence at a median time of 6 months (range 6–22 months). The 2-year actuarial local control and cause-specific survival for the entire group were 88% and 82.5%, respectively. In subset analysis, the crude local control was 100% for primary vaginal cancer, 100% for the group with recurrence without any prior radiation and 67% for group with recurrence and prior radiation therapy. Two patients had late grade 3 or higher morbidity (rectovaginal fistula in one patient and chronic vaginal ulcer resulting in bleeding in one patient). Both these patients had prior radiation therapy. CONCLUSION: Our small series suggests that HDRB is efficacious for primary or recurrent vaginal cancer. Patients treated with primary disease and those with recurrent disease without prior irradiation have the greatest benefit from HDRB in this setting. The salvage rate for patients with prior radiation therapy is lower with a higher risk of significant complications. Additional patients and follow-up are ongoing to determine the long-term efficacy of this approach.
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spelling pubmed-22702812008-03-20 High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina Beriwal, Sushil Heron, Dwight E Mogus, Robert Edwards, Robert P Kelley, Joseph L Sukumvanich, Paniti Radiat Oncol Study Protocol PURPOSE: The purpose of this study was to evaluate the efficacy of HDR brachytherapy for primary or recurrent vaginal cancer. METHODS: Between the years 2000 to 2006, 18 patients with primary or recurrent vaginal cancer were treated with brachytherapy (HDRB). Six patients had primary vaginal cancer (stage II to IVA) while 12 were treated for isolated vaginal recurrence (primary cervix = 4, vulva = 1 and endometrium = 7). Five patients had previous pelvic radiation therapy. All except one patient received external beam radiation therapy to a median dose of 45 Gy (range 31.2–55.8 Gy). The HDRB was intracavitary using a vaginal cylinder in 5 patients and interstitial using a modified Syed-Nesblett template in 13 patients. The dose of interstitial brachytherapy was 18.75 Gy in 5 fractions delivered twice daily. The median follow-up was 18 months (range 6–66 months). RESULTS: Complete response (CR) was achieved in all but one patient (94%). Of these 17 patients achieving a CR, 1 had local recurrence and 3 had systemic recurrence at a median time of 6 months (range 6–22 months). The 2-year actuarial local control and cause-specific survival for the entire group were 88% and 82.5%, respectively. In subset analysis, the crude local control was 100% for primary vaginal cancer, 100% for the group with recurrence without any prior radiation and 67% for group with recurrence and prior radiation therapy. Two patients had late grade 3 or higher morbidity (rectovaginal fistula in one patient and chronic vaginal ulcer resulting in bleeding in one patient). Both these patients had prior radiation therapy. CONCLUSION: Our small series suggests that HDRB is efficacious for primary or recurrent vaginal cancer. Patients treated with primary disease and those with recurrent disease without prior irradiation have the greatest benefit from HDRB in this setting. The salvage rate for patients with prior radiation therapy is lower with a higher risk of significant complications. Additional patients and follow-up are ongoing to determine the long-term efficacy of this approach. BioMed Central 2008-02-13 /pmc/articles/PMC2270281/ /pubmed/18271958 http://dx.doi.org/10.1186/1748-717X-3-7 Text en Copyright © 2008 Beriwal et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Study Protocol
Beriwal, Sushil
Heron, Dwight E
Mogus, Robert
Edwards, Robert P
Kelley, Joseph L
Sukumvanich, Paniti
High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina
title High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina
title_full High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina
title_fullStr High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina
title_full_unstemmed High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina
title_short High-dose rate brachytherapy (HDRB) for primary or recurrent cancer in the vagina
title_sort high-dose rate brachytherapy (hdrb) for primary or recurrent cancer in the vagina
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2270281/
https://www.ncbi.nlm.nih.gov/pubmed/18271958
http://dx.doi.org/10.1186/1748-717X-3-7
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