Nieto Karina, Martin Brendan, Pham Nghia, Palmere Laura, Silva Scott R, Winder Abigail, Liotta Margaret, Potkul Ronald K, Small William, Harkenrider Matthew M
Department of Obstetrics and Gynecology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL.
Clinical Research Office, Loyola University Chicago Health Sciences Division, Chicago, IL.
Brachytherapy. 2018 Nov-Dec;17(6):929-934. doi: 10.1016/j.brachy.2018.08.005. Epub 2018 Sep 15.
To compare radiation toxicity in endometrial cancer patients treated with adjuvant vaginal brachytherapy (VBT) vs. VBT with concurrent chemotherapy (CCT) or sequential chemotherapy (SCT) METHODS: We retrospectively analyzed 131 patients with endometrial cancer treated with VBT without external beam radiation therapy. Toxicities were graded according to the Common Terminology Criteria for Adverse Events v4.03. CCT was defined as VBT delivered between the first and last cycle of chemotherapy (CT); SCT was defined as VBT delivered before or after CT.
Median followup was 36 months, with a 3-year survival rate of 88%. Of the 131 patients, 92 were treated with VBT alone, 34 with VBT and CCT, and 5 with VBT and SCT. The most common toxicity was vaginal stricture, with 30 (22.9%) patients affected. The distribution of toxicities was vaginal 28%, urinary 12%, rectal 11%, and fatigue 5%; none greater than Grade 2. Compared with patients treated with VBT alone, the addition of CT did not increase the chance of vaginal stricture formation (p = 0.84). The difference in system-specific toxicities between treatment modalities was not statistically significant.
The most common pelvic toxicity from VBT is vaginal stenosis with other toxicities being infrequent and generally Grade 1. The addition of CT in a sequential or concurrent fashion did not increase the rate of pelvic toxicity from VBT alone.
比较接受辅助阴道近距离放射治疗（VBT）与接受VBT联合同步化疗（CCT）或序贯化疗（SCT）的子宫内膜癌患者的放射毒性。方法：我们回顾性分析了131例接受VBT且未接受外照射放疗的子宫内膜癌患者。毒性根据不良事件通用术语标准v4.03进行分级。CCT定义为在化疗（CT）的第一个周期和最后一个周期之间进行VBT；SCT定义为在CT之前或之后进行VBT。
中位随访时间为36个月，3年生存率为88%。131例患者中，92例仅接受VBT治疗，34例接受VBT和CCT治疗，5例接受VBT和SCT治疗。最常见的毒性是阴道狭窄，30例（22.9%）患者受影响。毒性分布为阴道28%、泌尿系统12%、直肠11%、疲劳5%；均不超过2级。与仅接受VBT治疗的患者相比，添加CT并未增加阴道狭窄形成的几率（p = 0.84）。不同治疗方式之间特定系统毒性的差异无统计学意义。
VBT最常见的盆腔毒性是阴道狭窄，其他毒性不常见且一般为1级。以序贯或同步方式添加CT并未增加单纯VBT的盆腔毒性发生率。
