open access

Vol 19, No 1 (2014)
Original research articles
Published online: 2014-01-01
Submitted: 2013-03-21
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Tolerance of the vaginal vault to high-dose rate brachytherapy and concomitant chemo-pelvic irradiation: Long-term perspective

Orit Kaidar-Person, Roxolyana Abdah-Bortnyak, Amnon Amit, Alexander Nevelsky, Alison Berniger, Raquel Bar-Deroma, Rahamim Ben-Yosef, Abraham Kuten
DOI: 10.1016/j.rpor.2013.09.005
·
Rep Pract Oncol Radiother 2014;19(1):56-61.

open access

Vol 19, No 1 (2014)
Original research articles
Published online: 2014-01-01
Submitted: 2013-03-21

Abstract

Aim/background

We sought to determine the tolerance level and complication rates of the vaginal vault to combined high-dose-rate intra-cavitary brachytherapy with concomitant chemo-radiotherapy.

Patients and methods

A retrospective review of medical records of all the patients who received definitive chemo-radiotherapy for cervical cancer between 1998 and 2002 was undertaken. The records were reviewed for doses and for radiation-associated early and late sequelae of the vagina, rectum and bladder. Cumulative biological effective dose was calculated for two reference vaginal surface points.

Results

Fifty patients were included. Average age at diagnosis was 54 years. Median follow-up was 59 months. There were no recorded instances of acute grade IV toxicity. Maximal high-dose-rate vaginal surface dose (upper central point) was 103[[ce:hsp sp="0.25"/]]Gy, and maximal brachytherapy lateral surface dose was 70[[ce:hsp sp="0.25"/]]Gy. Maximal cumulative biological effective dose for the lateral surface reference point was 465.5[[ce:hsp sp="0.25"/]]Gy3, and the maximal cumulative biological effective dose for the superior reference point was 878.6[[ce:hsp sp="0.25"/]]Gy3. There were no cases of vaginal necrosis or fistulas, and no cases of grade IV late vaginal, rectal or bladder toxicity. No correlation was found between the maximal vaginal surface dose and vaginal, rectal or bladder toxicity.

Conclusions

The maximal surface HDR brachytherapy dose of 103[[ce:hsp sp="0.25"/]]Gy and the maximal cBED of 878.6[[ce:hsp sp="0.25"/]]Gy3 were not associated with fistula or necrosis or other grade 3–4 vaginal complications. Concomitant chemo-radiotherapy, including pelvic radiotherapy and high-dose-rate intracavitary brachytherapy, is relatively safe for cervical cancer patients.

Abstract

Aim/background

We sought to determine the tolerance level and complication rates of the vaginal vault to combined high-dose-rate intra-cavitary brachytherapy with concomitant chemo-radiotherapy.

Patients and methods

A retrospective review of medical records of all the patients who received definitive chemo-radiotherapy for cervical cancer between 1998 and 2002 was undertaken. The records were reviewed for doses and for radiation-associated early and late sequelae of the vagina, rectum and bladder. Cumulative biological effective dose was calculated for two reference vaginal surface points.

Results

Fifty patients were included. Average age at diagnosis was 54 years. Median follow-up was 59 months. There were no recorded instances of acute grade IV toxicity. Maximal high-dose-rate vaginal surface dose (upper central point) was 103[[ce:hsp sp="0.25"/]]Gy, and maximal brachytherapy lateral surface dose was 70[[ce:hsp sp="0.25"/]]Gy. Maximal cumulative biological effective dose for the lateral surface reference point was 465.5[[ce:hsp sp="0.25"/]]Gy3, and the maximal cumulative biological effective dose for the superior reference point was 878.6[[ce:hsp sp="0.25"/]]Gy3. There were no cases of vaginal necrosis or fistulas, and no cases of grade IV late vaginal, rectal or bladder toxicity. No correlation was found between the maximal vaginal surface dose and vaginal, rectal or bladder toxicity.

Conclusions

The maximal surface HDR brachytherapy dose of 103[[ce:hsp sp="0.25"/]]Gy and the maximal cBED of 878.6[[ce:hsp sp="0.25"/]]Gy3 were not associated with fistula or necrosis or other grade 3–4 vaginal complications. Concomitant chemo-radiotherapy, including pelvic radiotherapy and high-dose-rate intracavitary brachytherapy, is relatively safe for cervical cancer patients.

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Keywords

Tolerance; Vagina; Irradiation; High-dose-rate; Brachytherapy

About this article
Title

Tolerance of the vaginal vault to high-dose rate brachytherapy and concomitant chemo-pelvic irradiation: Long-term perspective

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 19, No 1 (2014)

Pages

56-61

Published online

2014-01-01

DOI

10.1016/j.rpor.2013.09.005

Bibliographic record

Rep Pract Oncol Radiother 2014;19(1):56-61.

Keywords

Tolerance
Vagina
Irradiation
High-dose-rate
Brachytherapy

Authors

Orit Kaidar-Person
Roxolyana Abdah-Bortnyak
Amnon Amit
Alexander Nevelsky
Alison Berniger
Raquel Bar-Deroma
Rahamim Ben-Yosef
Abraham Kuten

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