High-dose-rate vaginal brachytherapy with chemotherapy for surgically staged localized uterine serous carcinoma

Authors

Shari Damast, Department of Therapeutic Radiology.
Susan A. Higgins, Department of Therapeutic Radiology.
Elena Ratner, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Yale University School of Medicine, New Haven, CT, USA.
Maria C. De Leon, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Yale University School of Medicine, New Haven, CT, USA.
Sheida Mani, Department of Therapeutic Radiology.
Dan-Arin Silasi, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Yale University School of Medicine, New Haven, CT, USA.
Masoud Azodi, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Yale University School of Medicine, New Haven, CT, USA.
Alessandro Santin, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Yale University School of Medicine, New Haven, CT, USA.
Thomas Rutherford, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Yale University School of Medicine, New Haven, CT, USA.
Peter E. Schwartz, Department of Obstetrics, Gynecology, and Reproductive Sciences, Division of Gynecologic Oncology, Yale University School of Medicine, New Haven, CT, USA.

Document Type

Article

Publication Title

Journal of contemporary brachytherapy

Abstract

PURPOSE: To evaluate our institutional experience combining carboplatin-paclitaxel (C/T) chemotherapy with high-dose-rate (HDR) intra-vaginal brachytherapy (IVB) following comprehensive surgical staging in localized uterine serous carcinoma (USC). MATERIAL AND METHODS: Institutional chart review identified 56 patients with FIGO 2009 stage I-II USC treated between 2000-2010. Patients underwent total hysterectomy, bilateral salpingo-oopherectomy, and comprehensive surgical staging including pelvic and para-aortic lymph node dissection, omentectomy, and peritoneal cytology. Chemotherapy was 6 cycles of C/T, and the IVB dose was 14 Gy in 2 fractions, prescribed to 0.5 cm from the cylinder surface. Kaplan-Meier methods were used to estimate recurrence-free survival (RFS) and overall survival (OS). RESULTS: The median follow-up time was 49 months (range: 9-145). The 5-yr RFS and OS were 85% and 93%, respectively. In all cases of recurrence (n = 8), the first site of failure was extra-pelvic. There were no isolated vaginal recurrences, however, there was one vaginal apex recurrence recorded at 19 months in a patient with simultaneous lung metastases. Thus, the 2-year vaginal RFS was 98%. CONCLUSIONS: Excellent vaginal/pelvic control rates were observed. Further study of HDR brachytherapy dose and fractionation in combination with chemotherapy is worthwhile.

First Page

35

Last Page

40

DOI

10.5114/jcb.2015.48539

Publication Date

2-1-2015

Recommended Citation

Damast, Shari; Higgins, Susan A.; Ratner, Elena; De Leon, Maria C.; Mani, Sheida; Silasi, Dan-Arin; Azodi, Masoud; Santin, Alessandro; Rutherford, Thomas; and Schwartz, Peter E., "High-dose-rate vaginal brachytherapy with chemotherapy for surgically staged localized uterine serous carcinoma" (2015). Obstetrics and Gynecology. 122.
https://scholar.bridgeporthospital.org/obgyn/122

Identifier

25829935 (pubmed); PMC4371058 (pmc); 10.5114/jcb.2015.48539 (doi); 24399 (pii)