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  • Results of image guided brachytherapy for stage IB cervical cancer in the RetroEMBRACE study
    Petrič, Primož ...
    Multiple treatment options are used in early local-stage cervical cancer, including combinations of surgery with neoadjuvant/adjuvant radiotherapy and chemotherapy. Our aim was to determine the ... outcome for definitive chemoradiation with image guided brachytherapy (IGBT). Methods: FIGO1994 staging system was used in our study. We included 123 patients with stage IB cervical cancer, treated at 12 centers with external beam radiotherapy (EBRT) % Chemotherapy and IGBT. Three- and 5-year actuarial local control (LC), pelvic control (PC), overall survival (OS), cancer-specific survival (CSS) and late morbidity (CTCAE v 3.0) were computed. Results: Median age was 48 (23-82) years. FIGO1994 stage distribution was: IB1 68% and IB2 32%; 41% of the entire cohort had nodal metastases and 73% squamous-cell carcinoma. MRI-based tumor size was >40 mm in 63%. Median EBRT dose was 45 (40-50) Gy; 84% received chemotherapy. At IGBT, mean CTV-HR D90 was 93 % 17 Gy (EQD210). D2cc for bladder was 76 % 14 Gy, rectum 66 % 11 Gy, sigmoid 66 % 10 Gy, bowel 67 % 7 Gy (EQD23). At 43-months median follow-up, 9% of patients had systemic, 6% paraaortic, 3% pelvic-nodal and 2% local failure. Five-year LC was 98%, PC 96%, CSS 90%, OS 83%. Intestinal G3--4 morbidity was 8%, urinary 7% and vaginal 0%. Conclusions: Chemoradiation with IGBT for FIGO1994 stage IB cervical cancer leads to excellent loco-regional control with limited morbidity. In IB node-negative disease, it can be regarded equivalent to surgery in terms of oncologic outcome. In tumors with unfavorable pre-treatment characteristics, chemoradiation is the first choice to avoid combining surgery with adjuvant therapy.
    Vir: Radiotherapy and oncology. - ISSN 0167-8140 (Vol. 157, 2021, str. 24-31)
    Vrsta gradiva - članek, sestavni del
    Leto - 2021
    Jezik - angleški
    COBISS.SI-ID - 66974979
    DOI

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