Background: This study aimed to evaluate the clinical outcomes
and dose-volume parameters of computed tomography CT-based brachytherapy for the
vaginal recurrence of uterine cancer after hysterectomy. Methods: We evaluated 22 uterine cancer patients treated with CT-based
brachytherapy for vaginal recurrence between December 2010 and August 2015.
Interstitial brachytherapy (ISBT) was used when the vaginal tumor was thicker
than 5 mm and/or located at extended extravaginal tissue, whereas intercavitary
brachytherapy was performed if it was 5 mm or thinner. Results: Overall,
11 patients had cervical cancer, and 11 had endometrial cancer. The median
pretreatment tumor size on magnetic resonance imaging was 17 mm (range, 0–45
mm). Four patients had vaginal recurrence recognized only in the gynecological
examination. The primary location of recurrence was the vagina, with extravaginal
extension observed in 9 patients. Seventeen patients (77%) received external
beam radiotherapy and brachytherapy. ISBT was performed in 12 patients (55%).
The median clinical target volume (CTV) D90 was 69.2 Gy (62.6–72.8 Gy). The
median D2cc of the bladder, sigmoid, and rectum were 70.2 (63.8–77.6), 37.4
(30.0–43.6), and 52.8 Gy (38.6–63.5 Gy), respectively. Complete response was
reached in all patients. The 5-year overall survival rate and local control rate
(LC) were 84.8 and 95.5%, respectively. No patient experienced grade
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Original Research
Outcomes and dose—volume parameters for computed tomography-based brachytherapy planning for vaginal recurrence of uterine cancer primarily treated with surgery
Keiko Nemoto Murofushi1,2,*, Reiko Tanaka1, Ayako Ohkawa1, Haruko Numajiri1, Toshiyuki Okumura1, Hideyuki Sakurai1
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1
Faculty of Medicine, Department of Radiation Oncology & Proton Medical Research Center, University of Tsukuba, Tsukuba, 305-8576 Ibaraki, Japan
2
Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, 113-8677 Tokyo, Japan
*Correspondence: murofushi@pmrc.tsukuba.ac.jp (Keiko Nemoto Murofushi)
Clin. Exp. Obstet. Gynecol. 2021, 48(3), 601–606;
https://doi.org/10.31083/j.ceog.2021.03.2437
Submitted: 29 December 2020 | Revised: 23 February 2021 | Accepted: 29 March 2021 | Published: 15 June 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract
Keywords
Vaginal recurrence
High-dose-rate brachytherapy
Intracavitary brachytherapy
Interstitial brachytherapy
Image-guided adaptive brachytherapy
Funding
18xx0000000 h 0001/Medical Research and Development (AMED)
Figures
Fig. 1.