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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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Main Authors: Meixner, Eva (Author) , Arians, Nathalie (Author) , Bougatf, Nina (Author) , Hoeltgen, Line (Author) , König, Laila (Author) , Uzun-Lang, Kristin (Author) , Domschke, Christoph (Author) , Wallwiener, Markus (Author) , Lischalk, Jonathan W. (Author) , Kommoss, Felix (Author) , Debus, Jürgen (Author) , Hörner-Rieber, Juliane (Author)
Format: Article (Journal)
Language:English
Published: 2023
In: Tumori journal
Year: 2023, Volume: 109, Issue: 1, Pages: 112-120
ISSN:2038-2529
DOI:10.1177/03008916211056369
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1177/03008916211056369
Verlag, kostenfrei, Volltext: https://journals.sagepub.com/doi/10.1177/03008916211056369
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Author Notes: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
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Summary: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.
Item Description:First published online November 1, 2021
Gesehen am 06.02.2023
Physical Description:Online Resource
ISSN:2038-2529
DOI:10.1177/03008916211056369

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