Preoperative brachytherapy of early-stage cervical cancer: A multicenter study by the SFRO brachytherapy group
To report the results of a multicenter cohort of preoperative brachytherapy (PBT) for treatment of early-stage cervical cancer (ESCC). A retrospective analysis was conducted among five French comprehensive cancer centers on behalf of the SFRO Brachytherapy Group to examine the outcome of patients wi...
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| Veröffentlicht in: | Gynecologic oncology 2024-09, Vol.188, p.90-96 |
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| creator | Ka, Kanta Cordoba, Abel Cagetti, Leonel Varela Schiappa, Renaud Kissel, Manon Escande, Alexandre Casabianca, Laurence Gonzague Buchalet, Chloe Gouy, Sebastien Morice, Philippe Narducci, Fabrice Martinez, Carlos Jauffret, Camille Lambaudie, Eric Delpech, Yann Laas, Enora Gaillard, Thomas Hannoun-Levi, Jean-Michel Espenel, Sophie Chargari, Cyrus |
| description | To report the results of a multicenter cohort of preoperative brachytherapy (PBT) for treatment of early-stage cervical cancer (ESCC).
A retrospective analysis was conducted among five French comprehensive cancer centers on behalf of the SFRO Brachytherapy Group to examine the outcome of patients with ESCC who received PBT between 2001 and 2019 because of adverse prognostic factors (tumor size >2 cm, presence of lymphovascular invasion, adenocarcinoma).Brachytherapy was followed 4–8 weeks later by surgery. Local relapse free, distant metastasis-free survival, disease-free, and overall survival and adverse effects were examined. Uni- and multivariate analyses were conducted looking for oncological prognostic factors.
A total of 451 patients were identified, with a mean tumor size of 24.7 mm. Adenocarcinoma accounted for 43.5% of cases, and lympho-vascular space invasion (LVSI) was present in 15.7%. A complete histological response was observed in 69.6%. With a mean follow-up of 75.4 months, DFS, LRFS, and OS rates at five years were 88% [95% CI (84–91), 98% [95% CI (96–99), and 92% [95% CI (87–95)], respectively. At the last follow-up, 8.2% of patients had died, including 31 (6.8%) from cervical cancer. Severe side effects range from 1.1% to 2%. At multivariate analysis, adenocarcinoma histological type, tumor size ≥2 cm, and the presence of residual tumors were prognosticators for DFS and DMFS.
PBT shows excellent oncological outcomes in this cohort of patients with adverse histoprognostic factors. Favorable survival rates and low complications rates were observed, supporting this strategy in the management of ESCC.
•Local recurrence-free survival, distant metastasis-free survival, and five-year overall survival: 88%, 98%, 92%.•Preoperative brachytherapy lowered adjuvant radiotherapy rates to 8.6% in early-stage cervical cancer.•70% of patients showed complete response post-brachytherapy, improving outcomes and reducing recurrence.•Serious complications were low, with only 1.1%–2% of patients experiencing severe side effects.•Significant prognostic factors: adenocarcinoma type, tumor size ≥2 cm, and presence of residual tumors. |
| doi_str_mv | 10.1016/j.ygyno.2024.06.010 |
| format | Article |
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A retrospective analysis was conducted among five French comprehensive cancer centers on behalf of the SFRO Brachytherapy Group to examine the outcome of patients with ESCC who received PBT between 2001 and 2019 because of adverse prognostic factors (tumor size >2 cm, presence of lymphovascular invasion, adenocarcinoma).Brachytherapy was followed 4–8 weeks later by surgery. Local relapse free, distant metastasis-free survival, disease-free, and overall survival and adverse effects were examined. Uni- and multivariate analyses were conducted looking for oncological prognostic factors.
A total of 451 patients were identified, with a mean tumor size of 24.7 mm. Adenocarcinoma accounted for 43.5% of cases, and lympho-vascular space invasion (LVSI) was present in 15.7%. A complete histological response was observed in 69.6%. With a mean follow-up of 75.4 months, DFS, LRFS, and OS rates at five years were 88% [95% CI (84–91), 98% [95% CI (96–99), and 92% [95% CI (87–95)], respectively. At the last follow-up, 8.2% of patients had died, including 31 (6.8%) from cervical cancer. Severe side effects range from 1.1% to 2%. At multivariate analysis, adenocarcinoma histological type, tumor size ≥2 cm, and the presence of residual tumors were prognosticators for DFS and DMFS.
PBT shows excellent oncological outcomes in this cohort of patients with adverse histoprognostic factors. Favorable survival rates and low complications rates were observed, supporting this strategy in the management of ESCC.
•Local recurrence-free survival, distant metastasis-free survival, and five-year overall survival: 88%, 98%, 92%.•Preoperative brachytherapy lowered adjuvant radiotherapy rates to 8.6% in early-stage cervical cancer.•70% of patients showed complete response post-brachytherapy, improving outcomes and reducing recurrence.•Serious complications were low, with only 1.1%–2% of patients experiencing severe side effects.•Significant prognostic factors: adenocarcinoma type, tumor size ≥2 cm, and presence of residual tumors.</description><identifier>ISSN: 0090-8258</identifier><identifier>ISSN: 1095-6859</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/j.ygyno.2024.06.010</identifier><identifier>PMID: 38941964</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma ; Adenocarcinoma - pathology ; Adenocarcinoma - radiotherapy ; Adult ; Aged ; Aged, 80 and over ; Brachytherapy - adverse effects ; Brachytherapy - methods ; Cervical cancer ; Female ; Humans ; Life Sciences ; Middle Aged ; Neoplasm Staging ; Preoperative brachytherapy ; Preoperative Care - methods ; Prognostic factors ; Retrospective Studies ; Surgery ; Uterine Cervical Neoplasms - mortality ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - radiotherapy</subject><ispartof>Gynecologic oncology, 2024-09, Vol.188, p.90-96</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c343t-8f8e4dc30f6e23542531ff425e9572c941e56033127af0f707ef9fdd3b37ae183</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090825824003251$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38941964$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.univ-lille.fr/hal-04905922$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Ka, Kanta</creatorcontrib><creatorcontrib>Cordoba, Abel</creatorcontrib><creatorcontrib>Cagetti, Leonel Varela</creatorcontrib><creatorcontrib>Schiappa, Renaud</creatorcontrib><creatorcontrib>Kissel, Manon</creatorcontrib><creatorcontrib>Escande, Alexandre</creatorcontrib><creatorcontrib>Casabianca, Laurence Gonzague</creatorcontrib><creatorcontrib>Buchalet, Chloe</creatorcontrib><creatorcontrib>Gouy, Sebastien</creatorcontrib><creatorcontrib>Morice, Philippe</creatorcontrib><creatorcontrib>Narducci, Fabrice</creatorcontrib><creatorcontrib>Martinez, Carlos</creatorcontrib><creatorcontrib>Jauffret, Camille</creatorcontrib><creatorcontrib>Lambaudie, Eric</creatorcontrib><creatorcontrib>Delpech, Yann</creatorcontrib><creatorcontrib>Laas, Enora</creatorcontrib><creatorcontrib>Gaillard, Thomas</creatorcontrib><creatorcontrib>Hannoun-Levi, Jean-Michel</creatorcontrib><creatorcontrib>Espenel, Sophie</creatorcontrib><creatorcontrib>Chargari, Cyrus</creatorcontrib><title>Preoperative brachytherapy of early-stage cervical cancer: A multicenter study by the SFRO brachytherapy group</title><title>Gynecologic oncology</title><addtitle>Gynecol Oncol</addtitle><description>To report the results of a multicenter cohort of preoperative brachytherapy (PBT) for treatment of early-stage cervical cancer (ESCC).
A retrospective analysis was conducted among five French comprehensive cancer centers on behalf of the SFRO Brachytherapy Group to examine the outcome of patients with ESCC who received PBT between 2001 and 2019 because of adverse prognostic factors (tumor size >2 cm, presence of lymphovascular invasion, adenocarcinoma).Brachytherapy was followed 4–8 weeks later by surgery. Local relapse free, distant metastasis-free survival, disease-free, and overall survival and adverse effects were examined. Uni- and multivariate analyses were conducted looking for oncological prognostic factors.
A total of 451 patients were identified, with a mean tumor size of 24.7 mm. Adenocarcinoma accounted for 43.5% of cases, and lympho-vascular space invasion (LVSI) was present in 15.7%. A complete histological response was observed in 69.6%. With a mean follow-up of 75.4 months, DFS, LRFS, and OS rates at five years were 88% [95% CI (84–91), 98% [95% CI (96–99), and 92% [95% CI (87–95)], respectively. At the last follow-up, 8.2% of patients had died, including 31 (6.8%) from cervical cancer. Severe side effects range from 1.1% to 2%. At multivariate analysis, adenocarcinoma histological type, tumor size ≥2 cm, and the presence of residual tumors were prognosticators for DFS and DMFS.
PBT shows excellent oncological outcomes in this cohort of patients with adverse histoprognostic factors. Favorable survival rates and low complications rates were observed, supporting this strategy in the management of ESCC.
•Local recurrence-free survival, distant metastasis-free survival, and five-year overall survival: 88%, 98%, 92%.•Preoperative brachytherapy lowered adjuvant radiotherapy rates to 8.6% in early-stage cervical cancer.•70% of patients showed complete response post-brachytherapy, improving outcomes and reducing recurrence.•Serious complications were low, with only 1.1%–2% of patients experiencing severe side effects.•Significant prognostic factors: adenocarcinoma type, tumor size ≥2 cm, and presence of residual tumors.</description><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - radiotherapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brachytherapy - adverse effects</subject><subject>Brachytherapy - methods</subject><subject>Cervical cancer</subject><subject>Female</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Preoperative brachytherapy</subject><subject>Preoperative Care - methods</subject><subject>Prognostic factors</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Uterine Cervical Neoplasms - mortality</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - radiotherapy</subject><issn>0090-8258</issn><issn>1095-6859</issn><issn>1095-6859</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoMo7rj6CwTJUQ_dVpL-iuBhWFxXGFjx4xwy6cpMhp5Om6QH-t-bcdY9ePBUVeF53wr1EvKaQcmANe8P5bJbRl9y4FUJTQkMnpAVA1kXTVfLp2QFIKHoeN1dkRcxHgBAAOPPyZXoZMVkU63I-DWgnzDo5E5It0Gb_ZL2eZ4W6i1FHYaliEnvkBoMJ2f0QI0ec_-BrulxHpIzOCYMNKa5X-h2oVlOv99-u__HbRf8PL0kz6weIr56qNfk5-2nHzd3xeb-85eb9aYwohKp6GyHVW8E2Aa5qCteC2ZtLijrlpv8eawbEILxVluwLbRope17sRWtRtaJa_Lu4rvXg5qCO-qwKK-dultv1PkNKgm15PzEMvv2wk7B_5oxJnV00eAw6BH9HJWAVjS1AFllVFxQE3yMAe2jNwN1DkUd1J9Q1DkUBY3KoWTVm4cF8_aI_aPmbwoZ-HgBMJ_k5DCoaBzmI_cuoEmq9-6_C34DxvSfDw</recordid><startdate>20240901</startdate><enddate>20240901</enddate><creator>Ka, Kanta</creator><creator>Cordoba, Abel</creator><creator>Cagetti, Leonel Varela</creator><creator>Schiappa, Renaud</creator><creator>Kissel, Manon</creator><creator>Escande, Alexandre</creator><creator>Casabianca, Laurence Gonzague</creator><creator>Buchalet, Chloe</creator><creator>Gouy, Sebastien</creator><creator>Morice, Philippe</creator><creator>Narducci, Fabrice</creator><creator>Martinez, Carlos</creator><creator>Jauffret, Camille</creator><creator>Lambaudie, Eric</creator><creator>Delpech, Yann</creator><creator>Laas, Enora</creator><creator>Gaillard, Thomas</creator><creator>Hannoun-Levi, Jean-Michel</creator><creator>Espenel, Sophie</creator><creator>Chargari, Cyrus</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope></search><sort><creationdate>20240901</creationdate><title>Preoperative brachytherapy of early-stage cervical cancer: A multicenter study by the SFRO brachytherapy group</title><author>Ka, Kanta ; Cordoba, Abel ; Cagetti, Leonel Varela ; Schiappa, Renaud ; Kissel, Manon ; Escande, Alexandre ; Casabianca, Laurence Gonzague ; Buchalet, Chloe ; Gouy, Sebastien ; Morice, Philippe ; Narducci, Fabrice ; Martinez, Carlos ; Jauffret, Camille ; Lambaudie, Eric ; Delpech, Yann ; Laas, Enora ; Gaillard, Thomas ; Hannoun-Levi, Jean-Michel ; Espenel, Sophie ; Chargari, Cyrus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c343t-8f8e4dc30f6e23542531ff425e9572c941e56033127af0f707ef9fdd3b37ae183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - radiotherapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brachytherapy - adverse effects</topic><topic>Brachytherapy - methods</topic><topic>Cervical cancer</topic><topic>Female</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Preoperative brachytherapy</topic><topic>Preoperative Care - methods</topic><topic>Prognostic factors</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Uterine Cervical Neoplasms - mortality</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - radiotherapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ka, Kanta</creatorcontrib><creatorcontrib>Cordoba, Abel</creatorcontrib><creatorcontrib>Cagetti, Leonel Varela</creatorcontrib><creatorcontrib>Schiappa, Renaud</creatorcontrib><creatorcontrib>Kissel, Manon</creatorcontrib><creatorcontrib>Escande, Alexandre</creatorcontrib><creatorcontrib>Casabianca, Laurence Gonzague</creatorcontrib><creatorcontrib>Buchalet, Chloe</creatorcontrib><creatorcontrib>Gouy, Sebastien</creatorcontrib><creatorcontrib>Morice, Philippe</creatorcontrib><creatorcontrib>Narducci, Fabrice</creatorcontrib><creatorcontrib>Martinez, Carlos</creatorcontrib><creatorcontrib>Jauffret, Camille</creatorcontrib><creatorcontrib>Lambaudie, Eric</creatorcontrib><creatorcontrib>Delpech, Yann</creatorcontrib><creatorcontrib>Laas, Enora</creatorcontrib><creatorcontrib>Gaillard, Thomas</creatorcontrib><creatorcontrib>Hannoun-Levi, Jean-Michel</creatorcontrib><creatorcontrib>Espenel, Sophie</creatorcontrib><creatorcontrib>Chargari, Cyrus</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Gynecologic oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ka, Kanta</au><au>Cordoba, Abel</au><au>Cagetti, Leonel Varela</au><au>Schiappa, Renaud</au><au>Kissel, Manon</au><au>Escande, Alexandre</au><au>Casabianca, Laurence Gonzague</au><au>Buchalet, Chloe</au><au>Gouy, Sebastien</au><au>Morice, Philippe</au><au>Narducci, Fabrice</au><au>Martinez, Carlos</au><au>Jauffret, Camille</au><au>Lambaudie, Eric</au><au>Delpech, Yann</au><au>Laas, Enora</au><au>Gaillard, Thomas</au><au>Hannoun-Levi, Jean-Michel</au><au>Espenel, Sophie</au><au>Chargari, Cyrus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative brachytherapy of early-stage cervical cancer: A multicenter study by the SFRO brachytherapy group</atitle><jtitle>Gynecologic oncology</jtitle><addtitle>Gynecol Oncol</addtitle><date>2024-09-01</date><risdate>2024</risdate><volume>188</volume><spage>90</spage><epage>96</epage><pages>90-96</pages><issn>0090-8258</issn><issn>1095-6859</issn><eissn>1095-6859</eissn><abstract>To report the results of a multicenter cohort of preoperative brachytherapy (PBT) for treatment of early-stage cervical cancer (ESCC).
A retrospective analysis was conducted among five French comprehensive cancer centers on behalf of the SFRO Brachytherapy Group to examine the outcome of patients with ESCC who received PBT between 2001 and 2019 because of adverse prognostic factors (tumor size >2 cm, presence of lymphovascular invasion, adenocarcinoma).Brachytherapy was followed 4–8 weeks later by surgery. Local relapse free, distant metastasis-free survival, disease-free, and overall survival and adverse effects were examined. Uni- and multivariate analyses were conducted looking for oncological prognostic factors.
A total of 451 patients were identified, with a mean tumor size of 24.7 mm. Adenocarcinoma accounted for 43.5% of cases, and lympho-vascular space invasion (LVSI) was present in 15.7%. A complete histological response was observed in 69.6%. With a mean follow-up of 75.4 months, DFS, LRFS, and OS rates at five years were 88% [95% CI (84–91), 98% [95% CI (96–99), and 92% [95% CI (87–95)], respectively. At the last follow-up, 8.2% of patients had died, including 31 (6.8%) from cervical cancer. Severe side effects range from 1.1% to 2%. At multivariate analysis, adenocarcinoma histological type, tumor size ≥2 cm, and the presence of residual tumors were prognosticators for DFS and DMFS.
PBT shows excellent oncological outcomes in this cohort of patients with adverse histoprognostic factors. Favorable survival rates and low complications rates were observed, supporting this strategy in the management of ESCC.
•Local recurrence-free survival, distant metastasis-free survival, and five-year overall survival: 88%, 98%, 92%.•Preoperative brachytherapy lowered adjuvant radiotherapy rates to 8.6% in early-stage cervical cancer.•70% of patients showed complete response post-brachytherapy, improving outcomes and reducing recurrence.•Serious complications were low, with only 1.1%–2% of patients experiencing severe side effects.•Significant prognostic factors: adenocarcinoma type, tumor size ≥2 cm, and presence of residual tumors.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38941964</pmid><doi>10.1016/j.ygyno.2024.06.010</doi><tpages>7</tpages></addata></record> |
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| subjects | Adenocarcinoma Adenocarcinoma - pathology Adenocarcinoma - radiotherapy Adult Aged Aged, 80 and over Brachytherapy - adverse effects Brachytherapy - methods Cervical cancer Female Humans Life Sciences Middle Aged Neoplasm Staging Preoperative brachytherapy Preoperative Care - methods Prognostic factors Retrospective Studies Surgery Uterine Cervical Neoplasms - mortality Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - radiotherapy |
| title | Preoperative brachytherapy of early-stage cervical cancer: A multicenter study by the SFRO brachytherapy group |
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