Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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%).
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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%).
CONCLUSIONS: 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.
摘要：
背景：间质性和/或腔内近距离放射治疗是阴道癌治疗不可或缺的一部分，近距离放射治疗（BT）已显示出改善局部控制，总生存期（OS）和无病生存期（DFS）。我们研究的目的是分析近距离放射治疗对阴道癌患者的疗效和安全性。
方法：在2000年至2023年之间，对FIGOI-III期的27例阴道癌患者进行了近距离放射治疗，有或没有外束放射治疗（EBRT）和同步化疗。已单独进行PDR近距离放射治疗，中位累积剂量高达62.5Gy（EQD2=63.9Gy），或进行PDR-BT增强，中位剂量为30.9Gy（EQD2=30.4Gy）。HDR-BT仅作为增强剂施用,中位剂量为25.5Gy(EQD2=47.8Gy)。对于原发性和盆腔淋巴结，EBRT的中位剂量为48.7Gy和49.4Gy。
结果：中位随访时间为39个月（2-120）。5/27例患者出现局部复发，整个患者群体的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期的5年DFS为72％，III期为65％（p=0.933）。3/22患者（13.6%）记录了近距离放射治疗的3级晚期副作用，1例患者出现4级毒性(4.5%).
结论：对于阴道癌，有或没有EBRT和伴随化疗的近距离放射治疗是一种安全有效的治疗选择，具有良好的局部控制和总生存期以及可接受的毒性。
方法：在2000年至2023年之间，对FIGOI-III期的27例阴道癌患者进行了近距离放射治疗，有或没有外束放射治疗（EBRT）和同步化疗。已单独进行PDR近距离放射治疗，中位累积剂量高达62.5Gy（EQD2=63.9Gy），或进行PDR-BT增强，中位剂量为30.9Gy（EQD2=30.4Gy）。HDR-BT仅作为增强剂施用,中位剂量为25.5Gy(EQD2=47.8Gy)。对于原发性和盆腔淋巴结，EBRT的中位剂量为48.7Gy和49.4Gy。
结果：中位随访时间为39个月（2-120）。5/27例患者出现局部复发，整个患者群体的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期的5年DFS为72％，III期为65％（p=0.933）。3/22患者（13.6%）记录了近距离放射治疗的3级晚期副作用，1例患者出现4级毒性(4.5%).
结论：对于阴道癌，有或没有EBRT和伴随化疗的近距离放射治疗是一种安全有效的治疗选择，具有良好的局部控制和总生存期以及可接受的毒性。
