Intraoperative electron beam radiotherapy and perioperative high-dose-rate brachytherapy in previously irradiated oligorecurrent gynecological cancer: clinical outcome analysis
Clin. transl. oncol. (Print)
; 23(9): 1934-1941, sept. 2021. ilus
Article
in English
| IBECS
| ID: ibc-222192
Responsible library:
ES1.1
Localization: ES15.1 - BNCS
ABSTRACT
Background Pelvic recurrences from previously irradiated gynecological cancer lack solid evidence for recommendation on salvage. Methods A total of 58 patients were included in this clinical analysis. Salvage surgery was performed for locoregional relapse within previously irradiated pelvic area after initial surgery and adjuvant radiotherapy or radical external beam radiotherapy. The primary tumor diagnosis included cervical cancer (n = 47, 81%), uterine cancer (n = 4, 7%), and other types (n = 7, 12%). Thirty-three patients received adjuvant IOERT (19842000) at a median dose of 15 Gy (range 1020 Gy) and 25 patients received adjuvant PHDRB (20012016) at a median dose of 32 Gy (range 2440 Gy) in 6, 8, or 10 b.i.d. fractions. Results The median follow-up was 5.6 years (range 0.514.2 years). Twenty-nine (50.0%) patients had positive surgical margins. Grade ≥ 3 toxic events were recorded in 34 (58.6%) patients. The local control rate at 2 years was 51% and remained stable up to 14 years. Disease-free survival rates at 2, 5, and 10 years were 17.2, 15.5, and 15.5%, respectively. Overall survival rates at 2, 5, and 10 years were 58.1, 17.8, and 17.8%, respectively. Conclusions IOERT and PHDRB account for an effective salvage in oligorecurrent gynecological tumors. Patients with previous pelvic radiation suitable for salvage surgery and at risk of inadequate margins could benefit from adjuvant reirradiation in form of IOERT or PHDRB. However, the rate of severe grade ≥ 3 toxicity associated with the entire treatment program is relevant and needs to be closely counterbalanced against the expected therapeutic gain (AU)
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Collection:
National databases
/
Spain
Database:
IBECS
Main subject:
Brachytherapy
/
Salvage Therapy
/
Electrons
/
Re-Irradiation
/
Genital Neoplasms, Female
/
Neoplasm Recurrence, Local
Limits:
Adult
/
Aged
/
Female
/
Humans
Language:
English
Journal:
Clin. transl. oncol. (Print)
Year:
2021
Document type:
Article
Institution/Affiliation country:
University of Navarra/Spain