Limits...
Bladder (ICRU) dose point does not predict urinary acute toxicity in adjuvant isolated vaginal vault high-dose-rate brachytherapy for intermediate-risk endometrial cancer.

Sapienza LG, Aiza A, Gomes MJ, Chen MJ, Pellizzon AC, Mansur DB, Baiocchi G - J Contemp Brachytherapy (2015)

Bottom Line: After a median follow-up of 36.8 months, the 3-year local failure and 5-year cancer-specific and overall survival rates were 2.1%, 100%, and 94.6%, respectively.No pelvic failure was seen in this cohort.Age over 60 years (p = 0.48), lymphatic invasion (p = 0.77), FIGO histological grade (p = 0.76), isthmus invasion (p = 0.68), and applicator type (cylinder × ovoid) (p = 0.82) did not significantly affect local control.

View Article: PubMed Central - PubMed

Affiliation: Clínicas Oncológicas Integradas (COI), Rio de Janeiro, Brazil ; A.C. Camargo Cancer Center, São Paulo, Brazil.

ABSTRACT

Purpose: High-dose-rate brachytherapy (HDR-BT) alone is an adjuvant treatment option for stage I intermediaterisk endometrial cancer after complete surgical resection. The aim of this study was to determine the value of the dose reported to ICRU bladder point in predicting acute urinary toxicity. Oncologic results are also presented.

Material and methods: One hundred twenty-six patients were treated with postoperative HDR-BT 24 Gy (4 × 6 Gy) per ICRU guidelines for dose reporting. Cox analysis was used to identify variables that affected local control. The mean bladder point dose was examined for its ability to predict acute urinary toxicity.

Results: Two patients (1.6%) developed grade 1 gastrointestinal toxicity and 12 patients (9.5%) developed grades 1-2 urinary toxicity. No grade 3 or greater toxicity was observed. The mean bladder point dose was 46.9% (11.256 Gy) and 49.8% (11.952 Gy) for the asymptomatic and symptomatic groups, respectively (p = 0.69). After a median follow-up of 36.8 months, the 3-year local failure and 5-year cancer-specific and overall survival rates were 2.1%, 100%, and 94.6%, respectively. No pelvic failure was seen in this cohort. Age over 60 years (p = 0.48), lymphatic invasion (p = 0.77), FIGO histological grade (p = 0.76), isthmus invasion (p = 0.68), and applicator type (cylinder × ovoid) (p = 0.82) did not significantly affect local control.

Conclusions: In this retrospective study, ICRU bladder point did not correlate with urinary toxicity. Four fractions of 6 Gy HDR-BT effected satisfactory local control, with acceptable urinary and gastrointestinal toxicity.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier survival tables. A) Incidence of vaginal failure. B) Overall survival. C) Incidence of vaginal failure as a function of age. D) Incidence of vaginal failure as a function of risk. LIR – low-intermediate-risk; HIR – high-intermediate-risk
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4663209&req=5

Figure 0002: Kaplan-Meier survival tables. A) Incidence of vaginal failure. B) Overall survival. C) Incidence of vaginal failure as a function of age. D) Incidence of vaginal failure as a function of risk. LIR – low-intermediate-risk; HIR – high-intermediate-risk

Mentions: For patients with more than 1 year of follow-up (n = 104), after a median of 36.8 months, there were 2 vaginal failures (both at 18 months of follow-up) and 2 deaths, none that was related to progression of endometrial cancer (1 case of acute myocardial infarction and 1 case of sepsis after an attempt at surgical removal of an intestinal adhesion). The 3-year LF rate was 2.1% (Figure 2A). The 5-year cancer-specific survival rate was 100%. As shown in Figure 2B, the 5-year OS was 94.6%. No pelvic failure was observed in this cohort. One patient developed distant metastasis to the lungs after 24 months of follow-up but remains alive after 1 year.


Bladder (ICRU) dose point does not predict urinary acute toxicity in adjuvant isolated vaginal vault high-dose-rate brachytherapy for intermediate-risk endometrial cancer.

Sapienza LG, Aiza A, Gomes MJ, Chen MJ, Pellizzon AC, Mansur DB, Baiocchi G - J Contemp Brachytherapy (2015)

Kaplan-Meier survival tables. A) Incidence of vaginal failure. B) Overall survival. C) Incidence of vaginal failure as a function of age. D) Incidence of vaginal failure as a function of risk. LIR – low-intermediate-risk; HIR – high-intermediate-risk
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663209&req=5

Figure 0002: Kaplan-Meier survival tables. A) Incidence of vaginal failure. B) Overall survival. C) Incidence of vaginal failure as a function of age. D) Incidence of vaginal failure as a function of risk. LIR – low-intermediate-risk; HIR – high-intermediate-risk
Mentions: For patients with more than 1 year of follow-up (n = 104), after a median of 36.8 months, there were 2 vaginal failures (both at 18 months of follow-up) and 2 deaths, none that was related to progression of endometrial cancer (1 case of acute myocardial infarction and 1 case of sepsis after an attempt at surgical removal of an intestinal adhesion). The 3-year LF rate was 2.1% (Figure 2A). The 5-year cancer-specific survival rate was 100%. As shown in Figure 2B, the 5-year OS was 94.6%. No pelvic failure was observed in this cohort. One patient developed distant metastasis to the lungs after 24 months of follow-up but remains alive after 1 year.

Bottom Line: After a median follow-up of 36.8 months, the 3-year local failure and 5-year cancer-specific and overall survival rates were 2.1%, 100%, and 94.6%, respectively.No pelvic failure was seen in this cohort.Age over 60 years (p = 0.48), lymphatic invasion (p = 0.77), FIGO histological grade (p = 0.76), isthmus invasion (p = 0.68), and applicator type (cylinder × ovoid) (p = 0.82) did not significantly affect local control.

View Article: PubMed Central - PubMed

Affiliation: Clínicas Oncológicas Integradas (COI), Rio de Janeiro, Brazil ; A.C. Camargo Cancer Center, São Paulo, Brazil.

ABSTRACT

Purpose: High-dose-rate brachytherapy (HDR-BT) alone is an adjuvant treatment option for stage I intermediaterisk endometrial cancer after complete surgical resection. The aim of this study was to determine the value of the dose reported to ICRU bladder point in predicting acute urinary toxicity. Oncologic results are also presented.

Material and methods: One hundred twenty-six patients were treated with postoperative HDR-BT 24 Gy (4 × 6 Gy) per ICRU guidelines for dose reporting. Cox analysis was used to identify variables that affected local control. The mean bladder point dose was examined for its ability to predict acute urinary toxicity.

Results: Two patients (1.6%) developed grade 1 gastrointestinal toxicity and 12 patients (9.5%) developed grades 1-2 urinary toxicity. No grade 3 or greater toxicity was observed. The mean bladder point dose was 46.9% (11.256 Gy) and 49.8% (11.952 Gy) for the asymptomatic and symptomatic groups, respectively (p = 0.69). After a median follow-up of 36.8 months, the 3-year local failure and 5-year cancer-specific and overall survival rates were 2.1%, 100%, and 94.6%, respectively. No pelvic failure was seen in this cohort. Age over 60 years (p = 0.48), lymphatic invasion (p = 0.77), FIGO histological grade (p = 0.76), isthmus invasion (p = 0.68), and applicator type (cylinder × ovoid) (p = 0.82) did not significantly affect local control.

Conclusions: In this retrospective study, ICRU bladder point did not correlate with urinary toxicity. Four fractions of 6 Gy HDR-BT effected satisfactory local control, with acceptable urinary and gastrointestinal toxicity.

No MeSH data available.


Related in: MedlinePlus