Clinical outcome of high-dose-rate interstitial brachytherapy in vulvar cancer: A single institutional experience

Mahantshetty, Umesh; Naga, Pushpa; Engineer, Reena; Sastri, S.; Ghadi, Yogesh; Upreti, Udita; Somesan, V; Kadam, Sonali; Kohle, Satish; Deshpande, Deepak D.; Shrivastava, Shyam Kishore

doi:10.1016/j.brachy.2016.10.003

Cited by 22 publications

(19 citation statements)

References 15 publications

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“…Of all the studies reviewed, only three salvage patients experienced severe treatment-related complications including one who developed a rectovaginal fistula and two who developed severe soft tissue necrosis ( 10 , 12 ). Mahantshetty et al also reported late toxicities in 22% including conservatively managed soft tissue necrosis, radiation proctitis, urethral stenosis, and skin and subcutaneous fibrosis ( 11 ). However, this was generalized for all patients and does not specify toxicity rates for salvage treatment.…”

Section: Discussionmentioning

confidence: 99%

“…However, 50% of patients relapsed with median time to failure of 31 months ( 10 ). Mahantshetty et al treated 38 patients, 3 of whom were treated for recurrent disease, and found 5-year overall survival, disease-free survival, and local control rates of 82, 51, and 77% respectively ( 11 ). Unfortunately, the specific results for salvage patients were not reported.…”

Section: Discussionmentioning

confidence: 99%

“…Patients in both of these studies were treated using HDR brachytherapy which has recently begun replacing low-dose rate (LDR) techniques which was the technique used for our patients. Compared to LDR, HDR brachytherapy is more convenient and allows for shorter treatment times and better optimization for patients with better radiation protection of the staff ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

“…Interstitial brachytherapy is an elegant technique delivering high-dose, focal radiotherapy which allows for a maximal radiation dose to be delivered to the tumor with minimal damage to nearby organs at risk. High-dose rate (HDR) interstitial brachytherapy has been used as a salvage treatment, however, only 11 patients have been reported on in the literature ( 10 , 11 ). One study reported on 8 salvage patients with median time to failure of 31 months and progression free survival at 1 and 3 years 100 and 62.5%, respectively.…”

Section: Introductionmentioning

confidence: 99%

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High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer

2017

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Vulvar cancer is a rare gynecological malignancy with incidence rates steadily increasing over the past 10 years. Despite aggressive treatment, recurrent disease is common. Vulvar cancer recurrence poses a significant therapeutic challenge as most patients have been previously treated with surgery and/or radiation limiting the options for additional treatment. There are no consensus guidelines for the treatment of recurrent disease. Current literature supports the use of salvage interstitial brachytherapy. However, the total sample size is small. The goal of this case report is to review the current literature and to provide a guide for the use of salvage interstitial brachytherapy for recurrent disease by describing, in detail, the techniques used to treat two patients with unique cases of vulvar cancer recurrences in women with advanced disease and multiple medical comorbidities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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High-Dose Rate Salvage Interstitial Brachytherapy: A Case-Based Guide to the Treatment of Therapeutically Challenging Recurrent Vulvar Cancer

2017

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“…Vulvo-vaginal cancers are rare with the average age of diagnosis 70 years and highest incidence in !90 years [62,63]. The use of brachytherapy boost in non-operable cases has been on the decline over the past decade despite improved disease specific survival and local control rates with combination treatment [64,65]. A small mixed case series in vaginal cancer showed a trend for improved outcome with combination treatment [66].…”

Section: Other Malignanciesmentioning

confidence: 99%

Practical brachytherapy solutions to an age-old quandary

Thiruthaneeswaran

Tharmalingam

Hoskin

2020

Technical Innovations & Patient Support in Radiation Oncolo

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Cancer is predominantly a disease of the elderly and as population life expectancy increases, so will the incidence of malignant disease. Elderly patients often have other comorbidities and social complexities, increasing the support required to safely deliver all treatment modalities. Brachytherapy is a relatively simple technique by which radiation therapy can be delivered. It offers dosimetric advantages through a highly conformal dose distribution thereby limiting radiation exposure to normal tissues reducing toxicity. Requiring fewer hospital visits, it also offers practical and logistical advantages to the elderly population and in many cases can be performed without the need for general anaesthesia. In tumour streams where brachytherapy forms part of the curative management, it should not be omitted in elderly patients who are medically fit for treatment. In the palliative setting, brachytherapy often offers an excellent means for achieving either local tumour and/or symptom control and should be actively considered in the therapeutic armamentarium of the oncologist in this context.

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