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Παρασκευή 22 Δεκεμβρίου 2017

Image-guided interstitial high-dose-rate brachytherapy for locally recurrent uterine cervical cancer: A single-institution study

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Publication date: Available online 21 December 2017
Source:Brachytherapy
Author(s): Rei Umezawa, Naoya Murakami, Satoshi Nakamura, Akihisa Wakita, Hiroyuki Okamoto, Keisuke Tsuchida, Tairo Kashihara, Kazuma Kobayashi, Ken Harada, Kana Takahashi, Koji Inaba, Yoshinori Ito, Hiroshi Igaki, Koji Masui, Ken Yoshida, Keiichi Jingu, Nikolaos Tselis, Jun Itami
PurposeThe aim of this study was to investigate the efficacy and safety of image-guided high-dose-rate (HDR) interstitial brachytherapy (ISBT) for reirradiation of locally recurrent uterine cervical cancer.Methods and MaterialsBetween 2008 and 2015, patients receiving reirradiation using HDR-ISBT for local gross recurrence of uterine cervical cancer after definitive or postoperative radiotherapy were analyzed retrospectively. The prescription doses per fraction ranged 2.5–6.0 Gy, whereas the cumulative equivalent doses in 2 Gy fractions ranged 48.6–82.5 Gy. The effects of prognostic factors on the local control (LC), progression-free survival, and overall survival were analyzed, and late toxicity data were evaluated.ResultsEighteen patients were included in the analysis, with a median followup of 18.1 months. A tumor response was obtained in all patients, with radiological and pathological complete remission seen in 12 (66.7%) patients. The 2-year LC, progression-free survival, and overall survival rates for all patients were 51.3%, 20.0%, and 60.8%, respectively. The hemoglobin level and maximum tumor diameter were shown to be statistically significant prognostic factors for LC (p = 0.028 and 0.009, respectively). Late ≥ Grade 2 adverse events were observed in 5 patients (27.8%).ConclusionsImage-guided HDR-ISBT for the reirradiation of locally recurrent uterine cervical cancer may play an important role for local tumor control in a subgroup of patients. However, the treatment indication must be weighed against the risk of higher-grade late toxicity.



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