A Retrospective Six Years Analysis of Survival and Late Morbidity of Post-operative Gynaecological Malignancy Treated with External Radiotherapy Followed by Brachytherapy in Medical College &amp; Hospitals, Kolkata

Sau, Sourav; Ghosh, Suparna; Mitra, Shila; Manna, Amalesh Kumar; Mondal, Bidyut; Ghosh, Kadambari

doi:10.1007/s13224-012-0246-5

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…also found the most common acute toxicities as vaginal inflammation, dyspareunia, fibrosis, and telangiectasias, like the current study. These findings were noted among cases with VBT with or without adjuvant chemotherapy [ 19 ]. However, there were no statistical differences in terms of acute or late vaginal toxicities between patients who underwent adjuvant chemotherapy and those who did not.…”

Section: Discussionmentioning

confidence: 86%

Combined external beam radiotherapy and vaginal brachytherapy versus vaginal brachytherapy in stage I, intermediate- and high-risk cases of endometrium carcinoma

Sunil

Bhavsar

Shruthi

et al. 2018

jcb

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PurposeRandomized trials on the effect of external beam radiotherapy (EBRT) with or without vaginal brachytherapy (VBT) for endometrial carcinoma are very few. In view of this, the current study was conducted with the hypothesizes: whether the escalated dose of 26 Gy (VBT alone) in comparison with various major international trials (PORTEC-2) has any difference in rates of disease-free and overall survival with fewer adverse effects in low resource setting like India.Material and methodsAn open-labeled, non-inferiority, randomized control trial was undertaken at a regional cancer center among patients with stage IA or IB high-intermediate risk endometrial carcinoma. A total of 50 patients were divided equally among two arms of combined EBRT with VBT (arm I) and VBT alone (arm II). A dose of 50-50.4 Gy in 25-28 fractions of EBRT with 2 fractions of VBT 6.5 Gy each were delivered to patients in arm I and 4 fractions of VBT 6.5 Gy each to patients in arm II, and were followed up for 60 months.ResultsDuring the median follow-up of 36.5 months, two patients developed loco-regional recurrence in arm II, three (arm II), and one (arm I) developed distant metastasis. The 5-year survival rates for arms I and II were 96.0% vs. 92.0% overall, and 88.0% vs. 84.0% disease-free, respectively, and were not found to be statistically significantly different. Dermatological, gastro-intestinal toxicities, and cystitis were lower in the VBT group compared to combined group.ConclusionsVBT alone is as effective as EBRT+VBT in ensuring loco-regional control and achieving comparable survival rates, with fewer toxic effects for patients with stage I intermediate- and high-risk endometrial carcinoma. The dose escalation did not make a difference in the survival rates and was like in the other major trials (PORTEC-2).

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Section: Discussionmentioning

confidence: 86%

Combined external beam radiotherapy and vaginal brachytherapy versus vaginal brachytherapy in stage I, intermediate- and high-risk cases of endometrium carcinoma

Sunil

Bhavsar

Shruthi

et al. 2018

jcb

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“…Cancers of the uterine cervix, endometrium and vagina account for 110,000 cases annually, and cause 10% of all cancer deaths [1]. Subtotal or simple hysterectomies usually without pelvic nodal dissection, in the presence of an occult cervical or endometrial cancer, are not a rare occurrence [2][3][4]. The cancer in these cases most commonly recurs as an inoperable pelvic mass.…”

Section: Purposementioning

confidence: 99%

Clinical outcomes of patients treated with template-based high-dose-rate interstitial brachytherapy boost for post-operative recurrent gynecological malignancies: A retrospective analysis

Mulye¹,

Gurram²,

Chopra³

et al. 2022

jcb

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Purpose To report the clinical outcomes in patients treated with Martinez universal perineal interstitial template (MUPIT)-based interstitial brachytherapy boost for primary and recurrent vault and vaginal cancers, and to perform a comparative analysis with our previously published series of similar patients. Material and methods One hundred and seventeen patients treated between January, 2009 and December, 2015 were evaluated. Descriptive statistics for the patterns of relapse, local recurrence-free survival (LRFS), disease-free survival (DFS), overall survival (OS), and late toxicities were carried out. Kaplan-Meier curves were used for survival analysis. All variables with the potential to affect outcomes were tested using log-rank test for statistical significance. Results At a median follow-up of 63 months, LRFS, DFS, and OS at 3/5 years were 77.1%/74.7%, 61%/52%, and 72.3%/63.1%, respectively. Overall treatment time (OTT) of 56 days did not affect outcomes. Bulky tumors and OTT > 63 days adversely affected LRFS. Overall treatment time also significantly impacted DFS and OS. Grade 3-4 late bladder toxicities were observed in 1.7% patients, and grade 3-4 late rectal toxicities in 5% patients. Compared to our previous series, the outcome in the current series is better in terms of severe late toxicities (5% improvement in rectal toxicity, and 2.7% improvement in bladder toxicity) and OS by 10%. This could be attributed to the increasing use of concurrent chemotherapy and relative optimization strategies for organs at risk. Conclusions Patients with primary and recurrent vault and vaginal cancers treated with high-dose-rate interstitial brachytherapy boost using MUPIT resulted in modest clinical outcomes and acceptable late toxicities. OTT was the most important factor affecting the outcomes.

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“…Approximately 15-19 % of patients are upstaged following additional surgery, arguing for re-operation when feasible to complete staging [31,32]. For those patients who have residual gross disease after subtotal hysterectomy, limited retrospective data suggest value in combined pelvic external beam radiotherapy and brachytherapy [33].…”

Section: Incidentally Discovered Incompletely Staged Endometrial Cancermentioning

confidence: 99%

Current Concepts in Radiation Therapy for Early-Stage Endometrial Cancer

Gill

Minkoff

Beriwal

2015

Indian J Gynecol Oncolog

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Purpose The present article aims to review current management for early-stage endometrioid carcinomas with a specific focus on adjuvant radiotherapy. Methods A comprehensive literature review was conducted regarding management of early-stage endometrioidtype endometrial cancers. Abstracted information included risk of relapse, treatment approach, and morbidity from treatment. Results A majority of low-risk patients are safely managed with observation, with vaginal cuff brachytherapy (VCBT) reserved for those with multiple other risk factors. Intermediate-risk patients are a heterogeneous group with a variable definition; previous trials have established that VCBT alone is suitable for most patients to avoid morbidity of pelvic external beam radiotherapy (EBRT). Highand high-intermediate risk patients warrant pelvic EBRT ± VCBT with or without sequential chemotherapy. Continued controversy exists regarding the optimal VCBT fractionation regimen, with suggestion that higher dose/ fraction regimens may lead to increased vaginal toxicity. Intensity-modulated radiotherapy is being investigated in an effort to reduce late toxicities. Advanced brachytherapy techniques such as image-guided brachytherapy have improved treatment of salvage and medically inoperable patients.Conclusions Identification of risk groups and toxicity reduction through either appropriate radiotherapy techniques or advanced techniques has enabled optimization of adjuvant management for early-stage endometrial cancer.

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A Retrospective Six Years Analysis of Survival and Late Morbidity of Post-operative Gynaecological Malignancy Treated with External Radiotherapy Followed by Brachytherapy in Medical College & Hospitals, Kolkata

Cited by 3 publications

References 13 publications

Combined external beam radiotherapy and vaginal brachytherapy versus vaginal brachytherapy in stage I, intermediate- and high-risk cases of endometrium carcinoma

Combined external beam radiotherapy and vaginal brachytherapy versus vaginal brachytherapy in stage I, intermediate- and high-risk cases of endometrium carcinoma

Clinical outcomes of patients treated with template-based high-dose-rate interstitial brachytherapy boost for post-operative recurrent gynecological malignancies: A retrospective analysis

Current Concepts in Radiation Therapy for Early-Stage Endometrial Cancer

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