Multi-institutional Analysis of Vaginal Brachytherapy Alone for Women With Stage II Endometrial Carcinoma
To investigate the survival endpoints in women with International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer who received adjuvant vaginal brachytherapy (VBT) alone using multi-institutional pooled data. We performed a multi-institutional analysis of surgically staged...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2018-08, Vol.101 (5), p.1069-1077 |
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| creator | Harkenrider, Matthew M. Martin, Brendan Nieto, Karina Small, Christina Aref, Ibrahim Bergman, David Chundury, Anupama Elshaikh, Mohamed A. Gaffney, David Jhingran, Anuja Lee, Larissa Paydar, Ima Ra, Kisuk Schwarz, Julie Thorpe, Cameron Viswanathan, Akila N. Small, William |
| description | To investigate the survival endpoints in women with International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer who received adjuvant vaginal brachytherapy (VBT) alone using multi-institutional pooled data.
We performed a multi-institutional analysis of surgically staged patients with FIGO stage II endometrioid-type endometrial cancer treated with VBT alone. Patient, tumor, and treatment characteristics were collected and analyzed. Univariable and multivariable frailty survival models were performed to assess clinicopathologic risk factors for recurrence and death.
One hundred six patients were included (92 VBT alone and 14 VBT with chemotherapy) with median follow-up of 39.0 months. Pelvic node dissection was performed in 89.6% of patients. One hundred four patients (98.1%) and 2 patients (1.9%) had microscopic and macroscopic cervical stromal invasion, respectively. Grade 1 or 2 disease occurred in 88.6% of patients. For patients treated with VBT without chemotherapy, the 5-year estimates of vaginal failure, pelvic nodal failure, and distant metastases were 2.6%, 4.2%, and 7.2%, respectively. Five-year progression-free survival and overall survival were 74.0% and 76.2%, respectively. On univariable and multivariable models for progression-free survival, increasing age and lack of pelvic node resection were hazardous (P |
| doi_str_mv | 10.1016/j.ijrobp.2018.04.049 |
| format | Article |
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We performed a multi-institutional analysis of surgically staged patients with FIGO stage II endometrioid-type endometrial cancer treated with VBT alone. Patient, tumor, and treatment characteristics were collected and analyzed. Univariable and multivariable frailty survival models were performed to assess clinicopathologic risk factors for recurrence and death.
One hundred six patients were included (92 VBT alone and 14 VBT with chemotherapy) with median follow-up of 39.0 months. Pelvic node dissection was performed in 89.6% of patients. One hundred four patients (98.1%) and 2 patients (1.9%) had microscopic and macroscopic cervical stromal invasion, respectively. Grade 1 or 2 disease occurred in 88.6% of patients. For patients treated with VBT without chemotherapy, the 5-year estimates of vaginal failure, pelvic nodal failure, and distant metastases were 2.6%, 4.2%, and 7.2%, respectively. Five-year progression-free survival and overall survival were 74.0% and 76.2%, respectively. On univariable and multivariable models for progression-free survival, increasing age and lack of pelvic node resection were hazardous (P < .05).
Vaginal and pelvic failure rates were low in this selected population of stage II patients receiving adjuvant VBT without external beam radiation therapy. It is reasonable to consider adjuvant VBT alone in selected patients with grade 1 or 2 disease and microscopic cervical stromal invasion who underwent pelvic lymphadenectomy.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2018.04.049</identifier><identifier>PMID: 29885996</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; BRACHYTHERAPY ; Brachytherapy - methods ; CARCINOMAS ; Disease Progression ; Endometrial Neoplasms - radiotherapy ; Female ; GYNECOLOGY ; Humans ; Kaplan-Meier Estimate ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; RADIOLOGY AND NUCLEAR MEDICINE ; Radiotherapy Dosage ; Radiotherapy, Adjuvant ; Recurrence ; Risk Factors ; Treatment Outcome ; Vagina - radiation effects ; WOMEN</subject><ispartof>International journal of radiation oncology, biology, physics, 2018-08, Vol.101 (5), p.1069-1077</ispartof><rights>2018</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-b99f385afd74583fff0e3a307450a2869d87313a7a008a4bbed8d39e35f131173</citedby><cites>FETCH-LOGICAL-c390t-b99f385afd74583fff0e3a307450a2869d87313a7a008a4bbed8d39e35f131173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijrobp.2018.04.049$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27922,27923,45993</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29885996$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/23065546$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Harkenrider, Matthew M.</creatorcontrib><creatorcontrib>Martin, Brendan</creatorcontrib><creatorcontrib>Nieto, Karina</creatorcontrib><creatorcontrib>Small, Christina</creatorcontrib><creatorcontrib>Aref, Ibrahim</creatorcontrib><creatorcontrib>Bergman, David</creatorcontrib><creatorcontrib>Chundury, Anupama</creatorcontrib><creatorcontrib>Elshaikh, Mohamed A.</creatorcontrib><creatorcontrib>Gaffney, David</creatorcontrib><creatorcontrib>Jhingran, Anuja</creatorcontrib><creatorcontrib>Lee, Larissa</creatorcontrib><creatorcontrib>Paydar, Ima</creatorcontrib><creatorcontrib>Ra, Kisuk</creatorcontrib><creatorcontrib>Schwarz, Julie</creatorcontrib><creatorcontrib>Thorpe, Cameron</creatorcontrib><creatorcontrib>Viswanathan, Akila N.</creatorcontrib><creatorcontrib>Small, William</creatorcontrib><title>Multi-institutional Analysis of Vaginal Brachytherapy Alone for Women With Stage II Endometrial Carcinoma</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>To investigate the survival endpoints in women with International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer who received adjuvant vaginal brachytherapy (VBT) alone using multi-institutional pooled data.
We performed a multi-institutional analysis of surgically staged patients with FIGO stage II endometrioid-type endometrial cancer treated with VBT alone. Patient, tumor, and treatment characteristics were collected and analyzed. Univariable and multivariable frailty survival models were performed to assess clinicopathologic risk factors for recurrence and death.
One hundred six patients were included (92 VBT alone and 14 VBT with chemotherapy) with median follow-up of 39.0 months. Pelvic node dissection was performed in 89.6% of patients. One hundred four patients (98.1%) and 2 patients (1.9%) had microscopic and macroscopic cervical stromal invasion, respectively. Grade 1 or 2 disease occurred in 88.6% of patients. For patients treated with VBT without chemotherapy, the 5-year estimates of vaginal failure, pelvic nodal failure, and distant metastases were 2.6%, 4.2%, and 7.2%, respectively. Five-year progression-free survival and overall survival were 74.0% and 76.2%, respectively. On univariable and multivariable models for progression-free survival, increasing age and lack of pelvic node resection were hazardous (P < .05).
Vaginal and pelvic failure rates were low in this selected population of stage II patients receiving adjuvant VBT without external beam radiation therapy. It is reasonable to consider adjuvant VBT alone in selected patients with grade 1 or 2 disease and microscopic cervical stromal invasion who underwent pelvic lymphadenectomy.</description><subject>Aged</subject><subject>BRACHYTHERAPY</subject><subject>Brachytherapy - methods</subject><subject>CARCINOMAS</subject><subject>Disease Progression</subject><subject>Endometrial Neoplasms - radiotherapy</subject><subject>Female</subject><subject>GYNECOLOGY</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Staging</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Adjuvant</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Vagina - radiation effects</subject><subject>WOMEN</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2LFDEQhoMo7uzoPxAJePHSs0mnP5KLMA7rOrCyh1XXW0inKzsZupMxSQvz703Tq8eFIiHFU6m36kXoHSUbSmhzddzYY_DdaVMSyjekyiFeoBXlrShYXf96iVaENaRgGb5AlzEeCSGUttVrdFEKzmshmhWy36Yh2cK6mGyakvVODXibj3O0EXuDf6pHO-c-B6UP53SAoE5nvB28A2x8wA9-BIcfbDrg-6QeAe_3-Nr1OZuCzXU7FbR1flRv0Cujhghvn-41-vHl-vvua3F7d7PfbW8LzQRJRSeEYbxWpm-rmjNjDAGmGMkvokreiJ63jDLVKkK4qroOet4zAaw2lOXx2Bp9WP71eSQZtU2gD9o7BzrJkpGmrqsmUx8X6hT87wlikqONGoZBOfBTlCWpWclZmSWsUbWgOvgYAxh5CnZU4SwpkbMV8igXK-RshSRVDpHL3j91mLoR-v9F_3afgU8LAHkbfyyEWSw4Db0Ns9be2-c7_AUnOJws</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Harkenrider, Matthew M.</creator><creator>Martin, Brendan</creator><creator>Nieto, Karina</creator><creator>Small, Christina</creator><creator>Aref, Ibrahim</creator><creator>Bergman, David</creator><creator>Chundury, Anupama</creator><creator>Elshaikh, Mohamed A.</creator><creator>Gaffney, David</creator><creator>Jhingran, Anuja</creator><creator>Lee, Larissa</creator><creator>Paydar, Ima</creator><creator>Ra, Kisuk</creator><creator>Schwarz, Julie</creator><creator>Thorpe, Cameron</creator><creator>Viswanathan, Akila N.</creator><creator>Small, William</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>OTOTI</scope></search><sort><creationdate>20180801</creationdate><title>Multi-institutional Analysis of Vaginal Brachytherapy Alone for Women With Stage II Endometrial Carcinoma</title><author>Harkenrider, Matthew M. ; Martin, Brendan ; Nieto, Karina ; Small, Christina ; Aref, Ibrahim ; Bergman, David ; Chundury, Anupama ; Elshaikh, Mohamed A. ; Gaffney, David ; Jhingran, Anuja ; Lee, Larissa ; Paydar, Ima ; Ra, Kisuk ; Schwarz, Julie ; Thorpe, Cameron ; Viswanathan, Akila N. ; Small, William</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-b99f385afd74583fff0e3a307450a2869d87313a7a008a4bbed8d39e35f131173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>BRACHYTHERAPY</topic><topic>Brachytherapy - methods</topic><topic>CARCINOMAS</topic><topic>Disease Progression</topic><topic>Endometrial Neoplasms - radiotherapy</topic><topic>Female</topic><topic>GYNECOLOGY</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Staging</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Adjuvant</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Vagina - radiation effects</topic><topic>WOMEN</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harkenrider, Matthew M.</creatorcontrib><creatorcontrib>Martin, Brendan</creatorcontrib><creatorcontrib>Nieto, Karina</creatorcontrib><creatorcontrib>Small, Christina</creatorcontrib><creatorcontrib>Aref, Ibrahim</creatorcontrib><creatorcontrib>Bergman, David</creatorcontrib><creatorcontrib>Chundury, Anupama</creatorcontrib><creatorcontrib>Elshaikh, Mohamed A.</creatorcontrib><creatorcontrib>Gaffney, David</creatorcontrib><creatorcontrib>Jhingran, Anuja</creatorcontrib><creatorcontrib>Lee, Larissa</creatorcontrib><creatorcontrib>Paydar, Ima</creatorcontrib><creatorcontrib>Ra, Kisuk</creatorcontrib><creatorcontrib>Schwarz, Julie</creatorcontrib><creatorcontrib>Thorpe, Cameron</creatorcontrib><creatorcontrib>Viswanathan, Akila N.</creatorcontrib><creatorcontrib>Small, William</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>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harkenrider, Matthew M.</au><au>Martin, Brendan</au><au>Nieto, Karina</au><au>Small, Christina</au><au>Aref, Ibrahim</au><au>Bergman, David</au><au>Chundury, Anupama</au><au>Elshaikh, Mohamed A.</au><au>Gaffney, David</au><au>Jhingran, Anuja</au><au>Lee, Larissa</au><au>Paydar, Ima</au><au>Ra, Kisuk</au><au>Schwarz, Julie</au><au>Thorpe, Cameron</au><au>Viswanathan, Akila N.</au><au>Small, William</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multi-institutional Analysis of Vaginal Brachytherapy Alone for Women With Stage II Endometrial Carcinoma</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>101</volume><issue>5</issue><spage>1069</spage><epage>1077</epage><pages>1069-1077</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>To investigate the survival endpoints in women with International Federation of Gynecology and Obstetrics (FIGO) stage II endometrial cancer who received adjuvant vaginal brachytherapy (VBT) alone using multi-institutional pooled data.
We performed a multi-institutional analysis of surgically staged patients with FIGO stage II endometrioid-type endometrial cancer treated with VBT alone. Patient, tumor, and treatment characteristics were collected and analyzed. Univariable and multivariable frailty survival models were performed to assess clinicopathologic risk factors for recurrence and death.
One hundred six patients were included (92 VBT alone and 14 VBT with chemotherapy) with median follow-up of 39.0 months. Pelvic node dissection was performed in 89.6% of patients. One hundred four patients (98.1%) and 2 patients (1.9%) had microscopic and macroscopic cervical stromal invasion, respectively. Grade 1 or 2 disease occurred in 88.6% of patients. For patients treated with VBT without chemotherapy, the 5-year estimates of vaginal failure, pelvic nodal failure, and distant metastases were 2.6%, 4.2%, and 7.2%, respectively. Five-year progression-free survival and overall survival were 74.0% and 76.2%, respectively. On univariable and multivariable models for progression-free survival, increasing age and lack of pelvic node resection were hazardous (P < .05).
Vaginal and pelvic failure rates were low in this selected population of stage II patients receiving adjuvant VBT without external beam radiation therapy. It is reasonable to consider adjuvant VBT alone in selected patients with grade 1 or 2 disease and microscopic cervical stromal invasion who underwent pelvic lymphadenectomy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29885996</pmid><doi>10.1016/j.ijrobp.2018.04.049</doi><tpages>9</tpages></addata></record> |
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| identifier | ISSN: 0360-3016 |
| ispartof | International journal of radiation oncology, biology, physics, 2018-08, Vol.101 (5), p.1069-1077 |
| issn | 0360-3016 1879-355X |
| language | eng |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged BRACHYTHERAPY Brachytherapy - methods CARCINOMAS Disease Progression Endometrial Neoplasms - radiotherapy Female GYNECOLOGY Humans Kaplan-Meier Estimate Middle Aged Neoplasm Recurrence, Local Neoplasm Staging RADIOLOGY AND NUCLEAR MEDICINE Radiotherapy Dosage Radiotherapy, Adjuvant Recurrence Risk Factors Treatment Outcome Vagina - radiation effects WOMEN |
| title | Multi-institutional Analysis of Vaginal Brachytherapy Alone for Women With Stage II Endometrial Carcinoma |
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