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Hypofractionated extracranial stereotactic radiotherapy boost for gynecologic tumors: a promising alternative to high-dose rate brachytherapy

Jorcano, Sandra
Molla, Meritxell
Escude, Lluis
Sanz, Sergi
Hidalgo, Alberto
Toscas, Jose Ignacio
Linero, Dolors
Published in Technology in Cancer Research and Treatment. 2010, vol. 9, no. 5, p. 509-514
Abstract The purpose of this study is to report toxicity and outcome results in patients with gynaecological tumours treated with a final boost using extra-cranial stereotactic radiotherapy (SRT) with a linac-based micro-multileaf collimator technique as an alternative to high-dose rate brachytherapy (HDR-BT). Since January 2002, 26 patients with either endometrial (n = 17) or cervical (n = 9) cancer were treated according to this protocol: 45-50.4 Gy external radiotherapy (RT) to the pelvic +/- para-aortic regions followed by a final SRT boost of 2 x 7 Gy to the vaginal vault (4-7 day interval between fractions). Median age was 62 years (37-74 range). Fifteen patients were diagnosed with adenocarcinoma, 7 with squamous-cell carcinoma, and 4 with sarcoma. FIGO stage I (n = 17), stage II (n = 7), and stage III (n = 2). Toxicity was scored according to RTOG/EORTC criteria. No severe (> grade-3) acute urinary or low-gastrointestinal (GI) toxicity was observed during treatment and up to 3 months after treatment completion. Moderate (grade ≤ 3) acute urinary or low-GI toxicity was observed in 23% and 35% of patients, respectively. After a median follow-up of 47 months (4-77, range), late urinary, low-GI, and sexual ≥ grade-2 (worst score) has been reported in 4%, 12% and 29.4% of patients, respectively. The 3-year loco-regional failure-free and overall survival rates were 96% and 95%, respectively. Preliminary results on feasibility, tolerance, and outcome with SRT are encouraging and may be considered a sound alternative to HDR-BT for gynecologic tumors.
Keywords AdultAgedBrachytherapy/*methodsFemaleGenital Neoplasms, Female/mortality/radiotherapy/*surgeryHumansMiddle AgedRadiosurgery/*methodsRadiotherapy Dosage
PMID: 20815422
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Research group Groupe Mirabell Raymond (radio-oncologie) (685)
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JORCANO, Sandra et al. Hypofractionated extracranial stereotactic radiotherapy boost for gynecologic tumors: a promising alternative to high-dose rate brachytherapy. In: Technology in Cancer Research and Treatment, 2010, vol. 9, n° 5, p. 509-514. doi: 10.1177/153303461000900509 https://archive-ouverte.unige.ch/unige:20492

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Deposited on : 2012-05-22

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