Die Vaginalstumpf-Rezidivrate beim Endometriumkarzinom in Abhängigkeit des Zielvolumens, der postoperativen HDR-Afterloading-Brachytherapie

Kloetzer, K H; Günther, R; Wendt, Thomas

doi:10.1007/bf03039188

Cited by 21 publications

(3 citation statements)

References 4 publications

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“…Nevertheless, an interesting study limiting the vaginal coverage to the upper 1 cm length has been reported, but only in the abstract form 80. Increasing the length of the vagina irradiation has been linked to an increase in toxicity,81 but no relationship has been described between the length of the vagina irradiation and vaginal relapses or survival 82…”

Section: Applicator Type and Position Patient Position And Volume Tomentioning

confidence: 99%

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Sabater¹,

Andrés²,

Lopez-Honrubia³

et al. 2017

CMAR

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Endometrial cancer (EC) is one of the most common gynecological cancers among women in the developed countries. Vaginal cuff is the main location of relapses after a curative surgical procedure and postoperative radiation therapy have proven to diminish it. Nevertheless, these results have not translated into better survival results. The preeminent place of vaginal cuff brachytherapy (VCB) in the postoperative treatment of high- to intermediate-risk EC was given by the PORTEC-2 trial, which demonstrated a similar reduction in relapses with VCB than with external beam radiotherapy (EBRT), but VCB induced less late toxicity. As a result of this trial, the use of VCB has increased in clinical practice at the expense of EBRT. A majority of the clinical reviews of VCB usually address the risk categories and patient selection but pay little attention to technical aspects of the VCB procedure. Our review aimed to address both aspects. First of all, we described the risk groups, which guide patient selection for VCB in clinical practice. Then, we depicted several technical aspects that might influence dose deposition and toxicity. Bladder distension and rectal distension as well as applicator position or patient position are some of those variables that we reviewed.

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Section: Applicator Type and Position Patient Position And Volume Tomentioning

confidence: 99%

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Sabater¹,

Andrés²,

Lopez-Honrubia³

et al. 2017

CMAR

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“…Sicher ist, daß die Strahlentherapie die Rate von lokoregionären Metastasen verringert [4,8,20,24]. Auch unsere vorgelegten Ergebnisse [21] Eine Beschränkung der Bestrahlung auf die Scheidenabschlußnarbe erscheint uns dabei als nicht ausreichend, da damit suburethrale Metastasen nicht verhindert werden kön-nen [12]. In Übereinstimmung mit anderen Therapeuten [7,15,20] halten wir die Durchführung der generellen postoperativen intravaginalen Kontakttherapie unter Einbeziehung der gesamten Scheide in das Zielvolumen für sinnvoll.…”

Section: Hänsgen G Et Al Postoperative Strahlentherapie Beim Endomeunclassified

Die postoperative Strahlentherapie beim Endometriumkarzinom Eine retrospektive Analyse von 541 Patienten

Hänsgen

Nagel²,

Dunst³

et al. 1999

Strahlenther Onkol

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“…The overall incidence of VSR in uterine body cancer after definitive surgery is reported as being 2.4–15% [1, 2]. Prophylaxis such as postoperative vaginal vault brachytherapy [3], additional vaginal cuff excision [4], or external beam radiotherapy with or without chemotherapy is recommended in high-risk patients [5–7]; however, because the stump tumor after hysterectomy is usually closely surrounded by radiosensitive organs (e.g. the rectum, sigmoid colon and/or small intestines [6, 8]), the safe radiation dose is limited and only small tumors are expected to be curable with brachytherapy [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Eradicative brachytherapy with hyaluronate gel injection into pararectal space in treatment of bulky vaginal stump recurrence of uterine cancer

Kishi¹,

Mabuchi²,

Sonomura³

et al. 2012

Journal of Radiation Research

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The purpose of this study is to develop a procedure for eradicative brachytherapy that can deliver a curative boost dose to bulky (>4 cm) vaginal stump recurrence of uterine cancer without risk of damaging surrounding organs. We separated risk organs (the rectum and sigmoid) from the target during brachytherapy, with a hyaluronate gel injection into the pararectal space via the percutaneous paraperineal approach under local anesthesia. The rectum anchored to the sacrum by native ligament was expected to shift posteriorly. We encountered a patient with bulky stump recurrence of uterine cancer, approximately 8 cm in maximum diameter. She was complaining of abdominal pain and constipation due to bowel encasement. Following 50 Gy of external beam radiotherapy, we applied a single fraction of brachytherapy under gel separation and delivered 14.5 Gy (50.8 GyE: equivalent dose in 2-Gy fraction calculated with linear quadratic model at α/β = 3) to the target. The gel injection procedure was completed in 30 min without complications. A total irradiation dose of 100.8 GyE was delivered to the target and the cumulative minimum dose to the most irradiated rectosigmoidal volume of 2 cc (cumulative D2cc) was calculated as 58.5 GyE with gel injection, and was estimated to be 96 GyE without. Over three years, the local stump tumor has completely disappeared, with no complications. Brachytherapy with a pararectal gel injection can be a safe and effective eradicative option for bulky vaginal stump recurrence.

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Die Vaginalstumpf-Rezidivrate beim Endometriumkarzinom in Abhängigkeit des Zielvolumens, der postoperativen HDR-Afterloading-Brachytherapie

Cited by 21 publications

References 4 publications

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Die postoperative Strahlentherapie beim Endometriumkarzinom Eine retrospektive Analyse von 541 Patienten

Eradicative brachytherapy with hyaluronate gel injection into pararectal space in treatment of bulky vaginal stump recurrence of uterine cancer

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Die Vaginalstumpf-Rezidivrate beim Endometriumkarzinom in Abhängigkeit des Zielvolumens, der postoperativen HDR-Afterloading-Brachytherapie

Cited by 21 publications

References 4 publications

Vaginal cuff brachytherapy in endometrial cancer &ndash; a technically easy treatment?

Vaginal cuff brachytherapy in endometrial cancer &ndash; a technically easy treatment?

Die postoperative Strahlentherapie beim Endometriumkarzinom Eine retrospektive Analyse von 541 Patienten

Eradicative brachytherapy with hyaluronate gel injection into pararectal space in treatment of bulky vaginal stump recurrence of uterine cancer

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Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?