Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.
Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; CCC WERA: Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; BZKF: Bavarian Cancer Research Center (BZKF), Erlangen, Germany.
Gynecol Oncol. 2024 Nov;190:35-41. doi: 10.1016/j.ygyno.2024.07.683. Epub 2024 Aug 16.
Interstitial and/or intracavitary brachytherapy is an integral part of the treatment of vaginal cancer Brachytherapy (BT) has shown to improve local control, overall survival (OS) and disease-free survival (DFS). The aim of our study was to analyze the efficacy and safety of brachytherapy in patients with vaginal cancer.
Between 2000 and 2023, 27 patients with vaginal cancer in stage FIGO I-III were treated with brachytherapy with or without external beam radiotherapy (EBRT) and simultaneous chemotherapy. Brachytherapy has been performed either as PDR-brachytherapy alone with a median cumulative dose up to 62.5 Gy (EQD2 = 63.9 Gy) or with PDR-BT boost with median dose of 30.9 Gy (EQD2 = 30.4 Gy). HDR-BT was administered solely as boost with a median dose of 25.5 Gy (EQD2 = 47.8 Gy). The median dose of EBRT was 48.7 Gy and 49.4 Gy for primary and for pelvic lymph nodes.
Median follow-up was 39 months (2-120). 5/27 patients developed local recurrences and the 5-year cumulative local recurrence rate for whole patient population was 18.5%. 5-year OS and DFS was 90% and 68%. 5-year DFS for Stage I-II was 72% and for Stage III 65% (p = 0.933). Grade 3 late side effects of brachytherapy were documented in 3/22 patients (13.6%), one patient experienced Grade 4 toxicity (4.5%).
Brachytherapy with or without EBRT and concomitant chemotherapy for vaginal cancer is a safe and effective treatment option with excellent local control and overall survival and acceptable toxicity.
间质和/或腔内近距离放射治疗是阴道癌治疗的一个组成部分。近距离放射治疗（BT）已被证明可提高局部控制率、总生存率（OS）和无病生存率（DFS）。我们的研究目的是分析 BT 在阴道癌患者中的疗效和安全性。
在 2000 年至 2023 年期间，27 名 FIGO I-III 期阴道癌患者接受了 BT 联合或不联合外部束放射治疗（EBRT）和同期化疗的治疗。BT 单独应用 PDR-BT，累积剂量中位数为 62.5Gy（EQD2=63.9Gy），或应用 PDR-BT 加量，剂量中位数为 30.9Gy（EQD2=30.4Gy）。HDR-BT 仅作为加量，剂量中位数为 25.5Gy（EQD2=47.8Gy）。EBRT 的中位剂量为 48.7Gy 和 49.4Gy，分别用于原发灶和盆腔淋巴结。
中位随访时间为 39 个月（2-120）。27 例患者中有 5 例发生局部复发，全患者人群的 5 年累积局部复发率为 18.5%。5 年 OS 和 DFS 分别为 90%和 68%。I-II 期患者的 5 年 DFS 为 72%，III 期患者的 5 年 DFS 为 65%（p=0.933）。22 例患者中有 3 例（13.6%）发生 3 级晚期 BT 毒性，1 例患者发生 4 级毒性（4.5%）。
BT 联合或不联合 EBRT 及同期化疗治疗阴道癌是一种安全有效的治疗选择，具有良好的局部控制率和总生存率，且毒性可接受。
