Outcomes with image-based interstitial brachytherapy for vaginal cancer.

Abstract

PURPOSE:

To compare clinical outcomes of image-based versus non-image-based interstitial brachytherapy (IBBT) for vaginal cancer.

METHODS AND MATERIALS:

Of 72 patients with vaginal cancer treated with brachytherapy (BT), 47 had image guidance (CT=31, MRI=16) and 25 did not. Kaplan-Meier (KM) estimates were generated for any recurrence, local control (LC), disease-free interval (DFI), and overall survival (OS) and Cox models were used to assess prognostic factors.

RESULTS:

Median age was 66 and median follow-up time was 24months. Median cumulative EQD2 dose was 80.8Gy in the non-IBBT group and 77Gy in the IBBT group. For non-IBBT versus IBBT, the 2-year KM LC was 71% vs. 93% (p=0.03); DFI was 54% vs. 86% (p=0.04); and OS 52% vs. 82% (p=0.35). On multivariate analysis, IBBT was associated with better DFI (HR 0.24, 95% CI 0.07-0.73). Having any 2 or more of chemotherapy, high-dose-rate (HDR) BT or IBBT (temporally correlated variables) significantly reduced risk of relapse (HR=0.33, 95% CI=0.13-0.83), compared to having none of these factors.

CONCLUSION:

Over time, the use of chemotherapy, HDR, and IBBT has increased in vaginal cancer. The combination of these factors resulted in the highest rates of disease control. Image-guided brachytherapy for vaginal cancer patients maximizes disease control.

• Authors: Matthias M Manuel, Linda P Cho, Paul J Catalano, Antonio L Damato, David T Miyamoto, Clare M Tempany, Ehud J Schmidt, Akila N Viswanathan
• Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology (Radiother Oncol) Vol. 120 Issue 3 Pg. 486-492 (09 2016) ISSN: 1879-0887 [Electronic] Ireland
• PMID: 27321150 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Topics

• Aged
• Brachytherapy (adverse effects, methods)
• Female
• Humans
• Kaplan-Meier Estimate
• Magnetic Resonance Imaging (methods)
• Middle Aged
• Neoplasm Recurrence, Local (etiology)
• Neoplasm Staging
• Prognosis
• Radiotherapy Dosage
• Radiotherapy, Image-Guided (adverse effects, methods)
• Retrospective Studies
• Tomography, X-Ray Computed (methods)
• Treatment Outcome
• Vaginal Neoplasms (diagnostic imaging, pathology, radiotherapy)