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Vaginal cancer treated with curative radiotherapy with or without concomitant chemotherapy: oncologic outcomes and prognostic factors

Background:Vaginal cancer is a rare disease for which prospective randomized trials do not exist. We aimed to assess survival outcomes, patterns of recurrence, prognostic factors, and toxicity in the curative treatment using image-guided radiotherapy (RT).Methods:In this retrospective review, we ide...

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Autori principali: Meixner, Eva (Autore) , Arians, Nathalie (Autore) , Bougatf, Nina (Autore) , Hoeltgen, Line (Autore) , König, Laila (Autore) , Uzun-Lang, Kristin (Autore) , Domschke, Christoph (Autore) , Wallwiener, Markus (Autore) , Lischalk, Jonathan W. (Autore) , Kommoss, Felix (Autore) , Debus, Jürgen (Autore) , Hörner-Rieber, Juliane (Autore)
Natura: Article (Journal)
Lingua:inglese
Pubblicazione: 2023
In: Tumori journal
Year: 2023, Volume: 109, Fascicolo: 1, Pages: 112-120
ISSN:2038-2529
DOI:10.1177/03008916211056369
Accesso online:Verlag, kostenfrei, Volltext: https://doi.org/10.1177/03008916211056369
Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/03008916211056369
Testo
Note sull'autore:Eva Meixner, Nathalie Arians, Nina Bougatf, Line Hoeltgen, Laila König, Kristin Lang, Christoph Domschke, Markus Wallwiener, Jonathan W. Lischalk, Felix K.F. Kommoss, Jürgen Debus and Juliane Hörner-Rieber
Descrizione
Riassunto:Background:Vaginal cancer is a rare disease for which prospective randomized trials do not exist. We aimed to assess survival outcomes, patterns of recurrence, prognostic factors, and toxicity in the curative treatment using image-guided radiotherapy (RT).Methods:In this retrospective review, we identified 53 patients who were treated at a single center with external beam radiotherapy and brachytherapy with or without concomitant chemotherapy from 2000 to 2021.Results:With a median follow-up of 64.5 months, the Kaplan-Meier 2-, 5-, and 7-year overall survival (OS) was found to be 74.8%, 62.8%, and 58.9%, respectively. Local and distant control were 67.8%, 65.0%, and 65.0% and 74.4%, 62.6%, and 62.6% at 2, 5, and 7 years, respectively. In univariate Cox proportional hazards ratio analysis, OS was significantly correlated to FIGO stage (hazard ratio [HR] 1.78, p = 0.042), postoperative RT (HR 0.41, p = 0.044), and concomitant chemotherapy (HR 0.31, p = 0.009). Local control rates were superior when an equivalent dose in 2-Gy fractions (EQD2) of ?65 Gy was delivered (HR 0.216, p = 0.028) and with the use of concurrent chemotherapy (HR 0.248, p = 0.011). Not surprisingly, local control was inferior for patients with a higher TNM stage (HR 3.303, p = 0.027). Minimal toxicity was observed with no patients having documentation of high-grade toxicity (CTCAE grade 3+).Conclusion:In treatment of vaginal cancer, high-dose RT in combination with brachytherapy is well tolerated and results in effective local control rates, which significantly improve with an EQD2(α/?=10) ?65 Gy. Multivariate analyses revealed concomitant chemotherapy was a positive prognostic factor for overall and progression-free survival.
Descrizione del documento:First published online November 1, 2021
Gesehen am 06.02.2023
Descrizione fisica:Online Resource
ISSN:2038-2529
DOI:10.1177/03008916211056369

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