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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 & 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 & 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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