An Asian multi-national, multi-institutional, retrospective study on image-guided brachytherapy in cervical adenocarcinoma and adenosquamous carcinoma

Issued Date

2022-01-01

Resource Type

Article

ISSN

1689832X

eISSN

20812841

DOI

10.5114/jcb.2022.119451

Scopus ID

2-s2.0-85140852107

Journal Title

Journal of Contemporary Brachytherapy

Volume

14

Issue

4

Start Page

311

End Page

320

Rights Holder(s)

SCOPUS

Bibliographic Citation

Journal of Contemporary Brachytherapy Vol.14 No.4 (2022) , 311-320

Suggested Citation

Okonogi N. An Asian multi-national, multi-institutional, retrospective study on image-guided brachytherapy in cervical adenocarcinoma and adenosquamous carcinoma. Journal of Contemporary Brachytherapy Vol.14 No.4 (2022) , 311-320. 320. doi:10.5114/jcb.2022.119451 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86262

Title

An Asian multi-national, multi-institutional, retrospective study on image-guided brachytherapy in cervical adenocarcinoma and adenosquamous carcinoma

Author(s)

Okonogi N.

Author's Affiliation

Hyogo Cancer Center
 Ramathibodi Hospital
 National Hospital Organization Fukuyama Medical Center
 Graduate School of Medicine
 Saitama Medical University International Medical Center
 Graduate School of Medicine
 QST Hospital
 Gunma Prefectural Cancer Center
 Jichi Medical University
 National Cancer Center, Gyeonggi
 Cancer Institute Hospital of Japan Foundation for Cancer Research
 National Cancer Center Hospital
 Niigata Cancer Center Hospital
 Juntendo University School of Medicine
 Chiba University Hospital
 Kita-Harima Medical Center

Other Contributor(s)

Mahidol University

Abstract

Purpose: There are limited reports on outcomes of three-dimensional image-guided brachytherapy (3D-IGBT) for cervical adenocarcinoma in Asia. In a multi-institutional retrospective study, we assessed the clinical outcomes of three-dimensional image-guided brachytherapy for cervical adenocarcinoma or adenosquamous carcinoma (CA/ CAC) in Asian countries. Material and methods: Patients who had undergone definitive radiation therapy/concurrent chemoradiotherapy for untreated cervical cancer between 2000 and 2016 were registered. Those who had undergone 3D-IGBT for histologically proven CA/CAC were included. Data on patients' characteristics and treatment were collected, including tumor reduction rate (defined as a percentage of reduction in tumor size before brachytherapy compared with that at diagnosis) and high-risk clinical target volume D90. Overall survival (OS), local control (LC), and progression-free survival (PFS) rates were calculated using Kaplan-Meier method. Late toxicities were assessed using common terminology criteria for adverse events version 4.0. Results: Anonymized data of 498 patients were collected. Of the 498 patients, 36 patients met inclusion criteria. The median follow-up period was 39 months. The 3-year OS, LC, and PFS rates were 68.4%, 68.5%, and 44.4%, respectively. After treatment, five patients had tumor re-growth without complete disappearance of the tumor. Two patients developed grade 3 vaginal toxicity or grade 4 rectal toxicity; none developed other severe late toxicities. A tumor reduction rate of > 26.3% was the only significant factor in multivariate analyses, and was associated with significantly better OS (p = 0.018), LC (p = 0.022), and PFS (p = 0.013). There were no significant trends in local control or dose to high-risk clinical target volume D90. Conclusions: LC rate of CA/CAC was insufficient despite 3D-IGBT. Meanwhile, tumor reduction rate was associated with LC, OS, and PFS rates. Therefore, CA/CAC may require a different treatment strategy than that applied in cervical squamous cell carcinoma.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/86262

Collections

Scopus 2022