KEY TAKEAWAYS
- The study aimed to investigate the efficacy and safety of definitive RT for the treatment of locally recurrent cervical and endometrial carcinoma.
- Researchers noted that 3D image-guided brachytherapy with EBRT effectively controls tumors with manageable toxicity.
The management of locally recurrent gynecological carcinoma remains a challenge due to the limited availability of data. This study aims to share the institutional experience in using definitive radiotherapy (RT) for the treatment of locally recurrent cervical and endometrial carcinoma.
Hui Cong and the team evaluated the outcomes of combining 3D image-guided brachytherapy with external beam radiotherapy (EBRT) to determine its effectiveness in controlling tumor recurrence and its associated toxicities.
They performed an inclusive analysis of 20 patients who underwent salvage 3D image-based HDR brachytherapy, with or without EBRT, for locally recurrent cervical and endometrial carcinoma after surgery. The Kaplan-Meier method was utilized to estimate disease-free survival (DFS) and overall survival (OS). Toxicities were assessed using the CTCAEv5 criteria.
About 21 months of median follow-up revealed a tumor objective response rate of 95%. The 3-year DFS and OS rates were 89.4% and 90.9%, respectively. The combination of EBRT and brachytherapy achieved a median cumulative dose of 88 Gy to CTV D90. Concurrent and/or systemic chemotherapy was given to 14 patients.
Locoregional recurrence was experienced in 2 patients after salvage treatment, with 1 having received only salvage brachytherapy due to a prior RT history. The analysis identified significant predictors for DFS, including tumor histology and FIGO stage. Acute grade 1-2 toxicities were observed in 5 patients, including rectal (15%) and genitourinary (10%) issues. Late toxicities included grade 1-2 rectal bleeding (10%) and a grade 2 pelvic fracture (5%) in 3 patients.
The study concluded that 3D image-guided brachytherapy combined with EBRT provides effective tumor control and an acceptable toxicity profile for women with locally recurrent gynecologic cancer. The success in managing vaginal recurrence is notably influenced by histologic subtype and FIGO staging.
The study was funded by the Science and Technology Project of the Shanghai Municipal Science and Technology Commission (No.22Y31900500).
Source: https://pubmed.ncbi.nlm.nih.gov/39030527/
Cong H, Yang X, Li Z, et al. (2024). “Salvage radiotherapy for locally recurrent cervical and endometrial carcinoma: clinical outcomes and toxicities.” BMC Cancer. 2024 Jul 19;24(1):871. doi: 10.1186/s12885-024-12617-8. PMID: 39030527.
