Merten Ricarda, Strnad Vratislav, Schweizer Claudia, Lotter Michael, Kreppner Stephan, Fietkau Rainer, Schubert Philipp, Karius Andre
Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054 Erlangen, Germany.
CCC Erlangen-EMN, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), 91054 Erlangen, Germany.
J Pers Med. 2024 Dec 3;14(12):1138. doi: 10.3390/jpm14121138.
: Radiotherapy represents the only treatment option for patients with inoperable endometrial cancer (EC). The aim of our study was to evaluate the efficacy and safety of brachytherapy (BT) in this selected patient population. : Between 1990 and 2019, 18 patients with inoperable EC in stage FIGO I-IV were treated with intracavitary brachytherapy using the "Heyman Packing technique". BT was performed either as sole PDR- or HDR-brachytherapy with a median cumulative dose up to 60.0 Gy (67.9 Gy ) and 34.0 Gy (75.6 Gy ), respectively. : The median follow-up was 46 months (6-219). The mean age was 71 years. The 5-year cumulative local recurrence rate (CLRR) for the whole cohort was 27.3%. The 5-year overall survival (OS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 51%, 79%, and 69%. The 5-year DFS for low-, intermediate-, and high-risk EC was 89%, 50%, and 44% ( = 0.51). No significant difference in DFS was observed in patients over 70 ( = 0.526). No late side effects of grade > 1 were documented. : Brachytherapy for inoperable EC is a safe and effective treatment option, offering good local control and OS with minimal toxicity. Moreover, brachytherapy effectively controls hemoglobin-relevant bleeding. Therefore, BT should be considered a viable alternative to non-curative treatment strategies in gynecological multidisciplinary conferences.
放射治疗是无法手术的子宫内膜癌（EC）患者的唯一治疗选择。我们研究的目的是评估近距离放射治疗（BT）在这一特定患者群体中的疗效和安全性。1990年至2019年期间，18例FIGO I-IV期无法手术的EC患者采用“Heyman填塞技术”进行腔内近距离放射治疗。BT分别作为单独的脉冲剂量率（PDR）或高剂量率（HDR）近距离放射治疗进行，中位累积剂量分别高达60.0 Gy（67.9 Gy）和34.0 Gy（75.6 Gy）。中位随访时间为46个月（6-219个月）。平均年龄为71岁。整个队列的5年累积局部复发率（CLRR）为27.3%。5年总生存率（OS）、无远处转移生存率（DMFS）和无病生存率（DFS）分别为51%、79%和69%。低、中、高危EC的5年DFS分别为89%、50%和44%（P=0.51）。70岁以上患者的DFS无显著差异（P=0.526）。未记录到大于1级的晚期副作用。对于无法手术的EC，近距离放射治疗是一种安全有效的治疗选择，能提供良好的局部控制和总生存率，且毒性最小。此外，近距离放射治疗能有效控制与血红蛋白相关的出血。因此，在妇科多学科会议上，BT应被视为非治愈性治疗策略的可行替代方案。
