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.
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。