High-dose-rate (HDR) brachytherapy with or without external beam radiotherapy in the treatment of primary vaginal carcinoma: Long-term results and side effects

Mock, Ulrike; Kucera, H; Fellner, Claudia; Knocke, Thomas Hendrik; Pötter, Richard

doi:10.1016/s0360-3016(03)00217-7

Cited by 69 publications

(32 citation statements)

References 17 publications

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“…We observed severe acute side effects (grade 3-4) at a rate of 24.4%, which is slightly lower than the average rate described in the literature (up to 40%) [24]. Due to a large variation in classification systems describing radiation treatment-related complications, it is difficult to compare multiple studies [10].…”

Section: Discussioncontrasting

confidence: 54%

“…Due to a large variation in classification systems describing radiation treatment-related complications, it is difficult to compare multiple studies [10]. Nevertheless, serious side effects were reported in 4% and 16% [4,8,18,20,24,37]. In our group, three patients (7.3%) experienced grade 3 or 4 late toxicities: one had a rectovesical fistula, one showed epithelial necrosis, and one had radiation colitis.…”

Section: Discussionmentioning

confidence: 81%

“…In general, external-beam radiotherapy is used, followed by some form of brachytherapy, depending on the tumor response. For small superficial lesions or for elderly patients with extensive comorbidities, brachytherapy alone may be considered [9,17,24,25,42].…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Results of Radiotherapy in Primary Carcinoma of the Vagina

et al. 2009

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Background:The long-term results of radiotherapy in primary carcinoma of the vagina are not well defined. Patients and Methods: The treatment results of 41 patients with primary malignancies of the vagina were analyzed. The mean follow-up period was 77.3 months (2.3-404 months). The predominant histology was squamous cell carcinoma, FIGO stages I: n = 7 (17.1%), II: n = 13 (31.7%), III: n = 13 (31.7%), and IVa: n = 8 (19.5%). Radiotherapy was the primary treatment for all patients. None of the patients had undergone prior surgery for vaginal carcinoma. The majority of patients received pelvic irradiation, including treatment of the inguinal lymphatics (median dose: 50 Gy). 26 patients received additional intravaginal brachytherapy. Results: Overall, 21 patients (51.2%) achieved complete remission, 17 patients (41.5%) had partial responses, and three patients (7.3%) had no change or progressive disease. The total median survival of the analyzed patients was 41.3 months. The 1-year survival probability was 85.4%, the 5-year survival probability 40.6%, and the 10-year survival probability 27.2%. Univariate analysis revealed a survival advantage for earlier tumor stages (FIGO I and II) compared to advanced stages (FIGO III and IV), with a median survival of 58.1 months compared to 26.8 months. Treatment side effects were tolerable and easily managed. Conclusion: Definite radiotherapy is the treatment of choice for primary carcinomas of the vagina. Considering that primary malignancies of the vagina are typically diseases of the elderly, it should be noted that radiotherapy is especially well tolerated in this population. Langzeitergebnisse der Strahlentherapie beim primären VaginalkarzinomHintergrund: Die Langzeitergebnisse der Strahlentherapie beim primären Vaginalkarzinom sind nicht gut definiert. Patienten und Methodik: Die Behandlungsergebnisse von 41 Patientinnen mit primären Vaginalkarzinomen wurden analysiert. Der mittlere Nachbeobachtungszeitraum betrug 77,3 Monate (2,3-404 Monate). Histologisch lagen überwiegend Plattenepithelkarzinome vor, FIGO-Stadien I: n = 7 (17,1%), II: n = 13 (31,7%), III: n = 13 (31,7%), IVa: n = 8 (19,5%). Bei allen Patientinnen war die Strahlentherapie die primäre Behandlungsform, keine Patientin hatte sich vor Bestrahlungsbeginn einer chirurgischen Intervention unterzogen. Der Großteil der Patientinnen erhielt eine Beckenbestrahlung, welche die inguinalen Lymphbahnen einschloss (mittlere Dosis: 50 Gy). 26 Patientinnen erhielten zusätzlich eine intravaginale Brachytherapie. Ergebnisse: Insgesamt erreichten 21 Patientinnen (51,2%) eine komplette Remission, 17 Patientinnen (41,5%) wiesen eine partielle Remission auf, und drei Patientinnen (7,3%) zeigten keine Veränderung bzw. ein Fortschreiten der Erkrankung. Das Gesamtüberleben für alle Patientinnen lag im Median bei 41,3 Monaten. Die 1-Jahres-Überlebenswahrscheinlichkeit betrug 85,4%, die 5-Jahres-Überlebenswahrscheinlichkeit 40,6% und die 10-Jahres-Überlebenswahrscheinlichkeit 27,2%. Die univariate Analyse zeigte einen Überlebensvo...

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 81%

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Long-Term Results of Radiotherapy in Primary Carcinoma of the Vagina

et al. 2009

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“…Depending on the bulk of residual disease following external beam irradiation, brachytherapy may be either intracavitary or interstitial (19,20).…”

Section: Vaginal Cancermentioning

confidence: 99%

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

Erickson

Demanes

Hayes³

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…The therapeutic approach in vaginal cancer depends on the tumor stage and localization and may include a local radical excision, partial or total colpectomy with paracolpic tissue +/-radical hysterectomy or radiochemotherapy and / or vaginal brachytherapy [1][2][3][4]. The most important prognostic parameter in vaginal cancer is the lymphatic status of the draining lymph nodes [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymphonodectomy in early vaginal cancer using combined near infrared fluorescence from indocyanine green and technetium-99m nanocolloid – a first case report

Soerge¹,

Hillemanns²,

Klapdor³

et al. 2017

Clin Obstet Gynecol Reprod Med

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Nowadays, sentinel diagnostic is been made with technetium-99m-(Tc-99m)-nanocolloide as a radioactive marker and sometimes patent blue. In the last years, indocyanin green has been evaluated for sentinel diagnostic in different tumor entities. Indocyane greene is a fluorescent molecule which emits a light signal in the near infrared band after excitation. Our study aims to evaluate indocyanin green compared to the gold standard Tc-99m-nanocolloid.We report over a patient with an unifocal vaginal cancer. Sentinel diagnostic was carried out using Tc-99m-nanocolloid, indocyanin green and patent blue. After SPECT/CT, we examined each groin for light signals from the near infrared band, for radioactivity and for blue staining. A sentinel lymph node was defined as a Tc99m-nanocolloide positive lymph node. All sentinel lymph nodes and all additional blue or fluorescent lymph nodes were excised and tested; then sent to histologic examination.The procedure could be accomplished without problems. We found four sentinel lymph nodes with indocyanin green fluorescence, which were positive for radioactivity from Tc-99m and therefore defined as sentinel lymph nodes. Two further lymph nodes, which showed positivity for indocyanin green signals, but not for Tc-99m were found in the left groin. The final tumor stage was pT1b, pN0 (0/6, 0/4 SLN). We saw no adverse events or complications in this patient.Our case report shows that near infrared fluorescence deriving from ICG is a promising approach for sentinel identification in vaginal cancer. If studies using sentinel lymphonodectomy will be planned, a combined approach using Tc-99m-nanocolloide and indocyanin green could be useful.

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High-dose-rate (HDR) brachytherapy with or without external beam radiotherapy in the treatment of primary vaginal carcinoma: Long-term results and side effects

Cited by 69 publications

References 17 publications

Long-Term Results of Radiotherapy in Primary Carcinoma of the Vagina

Long-Term Results of Radiotherapy in Primary Carcinoma of the Vagina

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

Sentinel lymphonodectomy in early vaginal cancer using combined near infrared fluorescence from indocyanine green and technetium-99m nanocolloid – a first case report

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