Adjuvant high dose rate vaginal brachytherapy as treatment of stage I and II endometrial carcinoma

Horowitz, Neil S.; Peters, William A.; Smith, Michael; Drescher, Charles W.; Atwood, Mary; Mate, Timothy P.

doi:10.1016/s0029-7844(01)01672-6

Cited by 94 publications

(42 citation statements)

References 12 publications

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“…Pelvic and para-aortic lymph node invasion were 11.4% and 5.3% respectively in our data. By the way of higher rates of pelvic and para-aortic lymph node invasion; lyphadenectomy seems valuable for endometrial cancer surgery (14,(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of FIGO 1988 Versus 2009 Staging for Endometrial Carcinoma

et al. 2017

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Objectives: The aim of this study was to investigate the benefits of the newly revised "The international federation of gynecology and obstetrics (FIGO), 2009" sytem and whether there was a difference in new system comparison to 1988 FİGO staging sytem for endometrial carcinoma. Methods: A total of 132 patients who underwent complete surgical staging for endometrial cancer were enrolled retrospectively. Those patients' overall survival and disease free survival were compared with 1988 and 2009 staging system. Results: The five year overall survival (OS) rates for patients with 1988 FIGO stage 1 and 2 were 97% and 100%, respectively. In 2009 system, the OS rates for 1 and 2 were 97% and 100%, respectively. There was no statistically significant differences between stage 1 and stage 2 for OS rates in 1988 and 2009 as well. Conclusions:The newly revised system could be less complex for understanding, but it does not discriminate survival rates better, especially in earlier stages. A new staging system and uniform surgical staging could be discussed.

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Section: Discussionmentioning

confidence: 99%

A Comparative Study of FIGO 1988 Versus 2009 Staging for Endometrial Carcinoma

et al. 2017

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“…Evidence of favorable clinical outcomes persists, especially an improved survival rate and a quicker treatment recovery time when using single‐channel VC HDR BT 2 , 4 , 5 , 6 , 7 . In particular, a simulation study by Barney et al (3) evaluating rectal and bladder toxicity using a single‐channel VC HDR BT reported that less than 5% of the patients (1 out of 24) developed a Grade 3 or higher toxicity level.…”

Section: Discussionmentioning

confidence: 99%

“…This is partly because the ICRU reference point is relative in position only to the VC applicator, which is chosen to fit tightly within the vaginal canal so to eliminate air gaps, (4) while the closest rectal point depends solely on the anatomical position of the rectum, and mostly varies between two patients even in VCs with a same diameter.…”

Section: Discussionmentioning

confidence: 99%

“…Radiation therapy after hysterectomy is the standard treatment for stage I–IV endometrial cancer. In particular, high‐dose‐rate (HDR) vaginal cuff brachytherapy (BT) without external beam radiation therapy (EBRT) has been widely used due to its efficacy, especially low local recurrence with minimal toxicity, low morbidity, and favorable quality of life after treatment 2 , 3 , 4 , 5 , 6 , 7 . The most common applicator used for HDR BT is a vaginal cylinder (VC) with a single, central channel (8) .…”

Section: Introductionmentioning

confidence: 99%

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Bladder and rectum dose estimations on digitized radiographs for vaginal brachytherapy after hysterectomy

Zhang

Bhatia

Sun

et al. 2014

J Applied Clin Med Phys

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The purpose of this study was to evaluate the feasibility of assessing bladder and rectal point doses, using orthogonal radiographs without treatment planning, for vaginal cylinder applicator (VC), high‐dose‐rate (HDR) vaginal cuff brachytherapy (BT) after hysterectomy. Thirty‐three VC HDR BT treatment plans from 31 postoperative endometrial cancer patients were retrospectively analyzed. Single‐channel VC with four differing diameters — 2.0 cm, 2.3 cm, 2.6 cm, and 3.0 cm — were analyzed. Dose‐distance modeling was performed to estimate bladder and rectal point doses by measuring distances on each orthogonal radiograph without treatment planning. The estimated doses were then compared with doses calculated on treatment planning system (TPS). Their percent (%) dose differences were recorded. Analysis was performed for each VC size, ICRU bladder and rectal points, and the closest rectal point. The estimated doses obtained from dose‐distance modeling displayed on average less than 2.5% difference when compared with TPS doses at ICRU bladder and rectal points for each VC size. Dose percent differences between estimated values and TPS values were on average 1.9% and 2.5% for ICRU bladder and rectal point, respectively, regardless of VC sizes. Dose‐distance modeling for closest rectal point presented on average 5.4% dose difference when compared with TPS values of all VC sizes. It was feasible to estimate rectal and bladder point doses by measuring distances on orthogonal radiographs without treatment planning. Percent dose differences were 2.5% less for both ICRU bladder and rectal points, regardless of VC sizes. The use of closest rectal point is not recommended for estimating rectal dose.PACS number: 87.53.‐j, 87.53.Jw, 87.55.‐x, 87.55.D‐, 87.55dk

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“…"sampling", liegt zum einen in der Tatsache, daß lediglich eine verminderte Aussage über den Nodalstatus gemacht werden kann, zum anderen sind bis zu 39% aller Lymphknotenmetastasen <2mm, so daß ein Befall nur in 10-31% makroskopisch verifiziert werden kann (Hirahatake et al, 1997). (Pfleiderer, 1991;Poulsen et al, 1997;Horowitz et al, 2002;Larson et al, 1998 Gesamtüberleben war jedoch statistisch nicht signifikant (Roberts et al, 1998). (Ball et al, 1996;Pfleiderer, 1991;Sutton et al, 1994).…”

Section: Anhand Dieser Prognosefaktoren Ist Es Möglich Die Indikatiounclassified

Prognosefaktoren des Endometriumkarzinoms - Ein Vergleich klinischer und immunhistochemisch bestimmter Parameter

Brohn¹,

Kullmer²,

Knoblauch³

et al. 2004

Geburtshilfe Frauenheilkd

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In den meisten Fällen erfolgt die Diagnose Endometriumkarzinom in einem frühen, doch auch in ca. 20 % in einem fortgeschrittenen Stadium. Welche tumorbiologischen Eigenschaften führen dazu, dass einige Endometriumkarzinome erst in fortgeschrittenen Stadien entdeckt werden? Material und Methodik: Ein Kollektiv von 183 Patientinnen mit Karzinomen des Endometriums wurde reevaluiert im Hinblick auf das klinische Follow-up sowie der Histopathologie (myometrane Tumorinvasionstiefe, Tumortyp, Grading, Lymphangiosis und Hämangiosis carcinomatosa, Tumornekrose). Zusätzlich erfolgten immunhistochemische Färbungen zur Detektion der Expression von Östrogen-und Progesteronrezeptor, Fibronektin und Faktor VII aktivierende Protease (FSAP) unter Verwendung der Streptavidin-Biotin-Methode. Mithilfe der Kaplan-Meier-Überlebenszeitanalyse wurden die prognostischen Parameter analysiert; bivariate Korrelationen sowie einfache und schrittweise Diskriminanzanalyse ermöglichten die Analyse der Relevanz der genannten Faktoren im Hinblick auf die Tumorprogression. Ergebnisse: Tumorstadium (FIGO) und Hämangiosis carcinomatosa konnten als wichtigste Prognosefaktoren des Endometriumkarzinoms identifiziert werden. Hinsichtlich der o. g. Fragestellung wurde die Lymphangiosis carcinomatosa als wichtigster

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Adjuvant high dose rate vaginal brachytherapy as treatment of stage I and II endometrial carcinoma

Abstract: Adjuvant high dose rate vaginal brachytherapy in thoroughly staged patients with intermediate-risk endometrial carcinoma provides excellent overall and disease-free survival with less toxicity and at less cost compared with whole-pelvic radiation.

Cited by 94 publications

References 12 publications

A Comparative Study of FIGO 1988 Versus 2009 Staging for Endometrial Carcinoma

A Comparative Study of FIGO 1988 Versus 2009 Staging for Endometrial Carcinoma

Bladder and rectum dose estimations on digitized radiographs for vaginal brachytherapy after hysterectomy

Prognosefaktoren des Endometriumkarzinoms - Ein Vergleich klinischer und immunhistochemisch bestimmter Parameter

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