Adjuvant vaginal interventional radiotherapy 
in early-stage non-endometrioid carcinoma 
of corpus uteri: a systematic review

Felice, Francesca De; Lancellotta, Valentina; Vicenzi, L.; Costantini, Sara; A, Antonacci; Cerboneschi, Valentina; Cristino, Daniela di; Tagliaferri, Luca; Cerrotta, Annamaria; Vavassori, Andrea; Gribaudo, Sergio; Colombo, Alessandro; Luca, Francesco De; Barbara, Raffaele; Mangoni, Monica; Marampon, Francesco; Musio, Daniela; Bellati, Filippo; Ruscito, Ilary; Torcia, F; Tombolini, Vincenzo; Osti, Mattia Falchetto; Sanctis, Vitaliana De

doi:10.5114/jcb.2021.105292

Cited by 2 publications

(5 citation statements)

References 55 publications

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Radiotherapy, chemotherapy, targeted therapy, and some investigated agents, as well as the combination of any of the above-mentioned therapies (called as multimodality treatment), are believed to provide potentially positive impacts on patients with UCS, and this adjuvant therapy is also apparently beneficial in those with an early UCS. [1][2][3][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] A recent meta-analysis summarizing four studies, which enrolled 2416 patients (939 patients treated with surgery plus postoperative chemotherapy and 1477 patients treated with surgery alone) found that 5-year overall survival (OS) was statistically significantly improved in the combination of surgery and adjuvant chemotherapy group compared to that in the surgery alone group, 23 suggesting that adjuvant chemotherapy should be considered in all UCS patients, regardless of what stages they are. The widely acceptable chemotherapy agents are platinum (either cisplatin or carboplatin), ifosfamide, and paclitaxel.…”

mentioning

confidence: 99%

“…Based on the key role of ifosfamide for the treatment of UCS, nearly all chemotherapy regimens, either single agent or multiagents included ifosfamide, although significant toxicities should be weighted. 2,22,32,33,37 Paclitaxel is considered as a potential agent for UCS, based on the experience on endometrial cancer. Additionally, combination of paclitaxel and platinum (paclitaxel-platinum regimen: PP) was widely used in the majority of gynecological organ-related cancers.…”

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confidence: 99%

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Comparing paclitaxel-platinum with ifosfamide-platinum as the front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma

Huang

et al. 2022

Journal of the Chinese Medical Association

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Malignant mixed Müllerian tumors (MMMT, carcinosarcomas [CS]) of female genital tract are defined histologically as a biphasic tumor consisting of both carcinoma (malignant epithelial elements) and sarcoma (malignant mesenchymal or stromal elements) components. 1-3 CS usually arises from the uterus but may also rarely appear in the ovary, Fallopian tube, cervix, or peritoneum. [4][5][6] In the past and traditionally, uterine CS (UCS) has been regarded as a subtype of uterine sarcomas and is often analyzed after grouping other uterine sarcomas, such as undifferentiated uterine sarcoma, endometrial stromal sarcoma, and leiomyosarcoma. [7][8][9][10] Recently, clinical, pathologic, and biological evidence has indicated that UCS is a monoclonal origin, which is derived from the Müllerian duct and closely related to high-grade endometrial carcinoma with the driving force to result in sarcomatous transformation (metaplastic carcinoma), and subsequently form the homologous or heterologous groups, depending on the characteristics of the stroma or mesenchymal components of endometrial tissues. [11][12][13] Primary complete surgical staging or primary cytoreductive surgery (PCS) is a key factor in the management of women with UCS, based on the studies obtained from the experience for high-grade or advanced endometrial cancer and uterine sarcomas as well as epithelial ovarian cancer, primary peritoneal serous carcinoma, and primary fallopian tube cancers. 10,14-21 PCS includes a total hysterectomy, bilateral salpingo-oophorectomy,

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Comparing paclitaxel-platinum with ifosfamide-platinum as the front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma

Huang

et al. 2022

Journal of the Chinese Medical Association

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“…Compared with EBRT or EBRT combined with VBT, VBT has better late toxicity sequences and offers a better quality of life. In addition to global health status, patients treated with VBT alone had a better social function [ 4 , 5 , 6 , 7 , 8 ]. Furthermore, the use of EBRT or EBRT combined with HDR-VBT resulted in higher treatment costs and higher toxicity without the survival benefit as compared to BT alone [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)

et al. 2021

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(1) Background: Postoperative vaginal-cuff HDR interventional radiotherapy (brachytherapy) is a standard treatment in early-stage endometrial cancer. This study reports the effect of in vivo dosimetry-based biological planning for two different fractionation schedules on the treatment-related toxicities. (2) Methods: 121 patients were treated. Group A (82) received 21 Gy in three fractions. Group B (39) received 20 Gy in four fractions. The dose was prescribed at a 5 mm depth or to the applicator surface according to the distance between the applicator and the rectum. In vivo dosimetry measured the dose of the rectum and/or urinary bladder. With a high measured dose, the dose prescription was changed from a 5 mm depth to the applicator surface. (3) Results: The median age was 66 years with 58.8 months mean follow-up. The dose prescription was changed in 20.7% of group A and in 41% of group B. Most toxicities were grade 1–2. Acute urinary toxicities were significantly higher in group A. The rates of acute and late urinary toxicities were significantly higher with a mean bladder dose/fraction of >2.5 Gy and a total bladder dose of >7.5 Gy. One patient had a vaginal recurrence. (4) Conclusions: Both schedules have excellent local control and acceptable rates of toxicities. Using in vivo dosimetry-based biological planning yielded an acceptable dose to the bladder and rectum.

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Adjuvant vaginal interventional radiotherapy in early-stage non-endometrioid carcinoma of corpus uteri: a systematic review

Cited by 2 publications

References 55 publications

Comparing paclitaxel-platinum with ifosfamide-platinum as the front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma

Comparing paclitaxel-platinum with ifosfamide-platinum as the front-line chemotherapy for patients with advanced-stage uterine carcinosarcoma

Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)

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