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Cited 3 time in webofscience Cited 4 time in scopus
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Comparison of treatment outcomes of pelvis external radiotherapy with and without vaginal brachytherapy for cervical cancer patients with positive or close vaginal resected margins

Authors
Lee, Yun HeeKim, Yeon SilChoi, Kyu HyeSung, SooYoonJeong, Bae KwonHa, In BongKang, Ki MunLee, JayoungLee, Jong HoonKim, Sung Hwan
Issue Date
Jan-2022
Publisher
SPRINGER JAPAN KK
Keywords
Cervical cancer; Brachytherapy; Resection margin
Citation
INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY, v.27, no.1, pp 202 - 212
Pages
11
Indexed
SCIE
SCOPUS
Journal Title
INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY
Volume
27
Number
1
Start Page
202
End Page
212
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/1795
DOI
10.1007/s10147-021-02037-0
ISSN
1341-9625
1437-7772
Abstract
Background We evaluated whether there is a difference in the local recurrence and survival after pelvic external radiotherapy (ERT) with and without boost vaginal brachytherapy (VB) in cervical cancer patients with positive or close vaginal resected margins (RM). Methods We retrospectively reviewed FIGO stage IA-IIB cervical cancer patients treated with postoperative ERT between 1997 and 2018. The sixty patients showing close (safety margin < 5 mm) or positive vaginal RM were included. ERT was delivered with median 50.4 Gy in 28 fractions to the pelvis and VB with median 30 Gy in 6 fractions. Results The median follow-up duration was 46 months. Five out of 30 patients treated with ERT alone experienced vaginal recurrence within 2 years after surgery. The 5-year local control (LC) was 100% in patients receiving ERT + VB compared with 81.3% in patients receiving ERT alone (log rank p = 0.022). The 5-year pelvic control (PC) was 95.8% for patients receiving ERT + VB and 76.8% for ERT alone (p = 0.041). The 5-year overall survival and recurrence-free survival (RFS) were not significantly different between treatment groups. In multivariate analysis, perineural invasion was a significant risk factor for PC (p = 0.024). Parametrial involvement (p = 0.044) and vascular invasion (p = 0.032) were unfavorable prognostic factors for RFS. Late toxicity occurrences were not significant in both groups. Conclusion VB after ERT improved LC and PC in cervical cancer patients with close or positive RM after hysterectomy. The toxicities were not increased after VB was added to ERT.
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