The impact of modern preoperative high-dose-rate brachytherapy in early-stage cervical cancer
| العنوان: | The impact of modern preoperative high-dose-rate brachytherapy in early-stage cervical cancer |
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| المؤلفون: | Magalie Provansal, Eric Lambaudie, Guillaume Blache, Christophe Zemmour, Leonel Varela Cagetti, Laura Sabiani, Renaud Sabatier, Marjorie Ferre, Maria Paciencia, Agnès Tallet, Hugues Mailleux, Gilles Houvenaeghel, Camille Jauffret, Laurence Gonzague-Casabianca |
| المساهمون: | Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Malbec, Odile |
| المصدر: | Gynecologic Oncology Gynecologic Oncology, 2021, 161 (1), pp.166-172. ⟨10.1016/j.ygyno.2021.01.034⟩ |
| بيانات النشر: | HAL CCSD, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | 0301 basic medicine, Adult, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Brachytherapy, Uterine Cervical Neoplasms, Hysterectomy, Disease-Free Survival, Perioperative Care, 03 medical and health sciences, Image-guided adaptive brachytherapy, 0302 clinical medicine, Minimally invasive surgery, medicine, Humans, Minimally Invasive Surgical Procedures, Stage (cooking), Aged, Neoplasm Staging, Retrospective Studies, Cervical cancer, Aged, 80 and over, Wound dehiscence, business.industry, Obstetrics and Gynecology, Middle Aged, medicine.disease, Combined Modality Therapy, High-Dose Rate Brachytherapy, Surgery, [SDV] Life Sciences [q-bio], Preoperative brachytherapy, 030104 developmental biology, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Early-stage cervical cancer, Resection margin, Vaginal vault, Female, business, Radiotherapy, Image-Guided |
| الوصف: | International audience; Purpose: To analyze the clinical outcomes and the safety of preoperative high-dose-rate (HDR) image-guided adaptive brachytherapy (IGABT) followed by minimally invasive surgery (MIS) in the multidisciplinary management of early-stage cervical cancer.Methods and materials: Medical records of all consecutive patients with early-stage cervical cancer treated at our institution between 2012 and 2018 with preoperative IGABT in a multidisciplinary approach were reviewed. Treatment schedule was pelvic node dissection, preoperative IGABT followed 6-8 week later by MIS hysterectomy.Results: Seventy patients with cervical cancer FIGO stages (IB1 18.6%, IB2 75.7% and IIA1 5.7%) were treated by preoperative HDR brachytherapy. With a median follow-up of 37.4 months [95% confidence interval, 32.1-39.7 months] isolated vaginal vault recurrence was not observed, 3 pelvic relapses were reported (4.3%). None of patients received postoperative radiotherapy (EBRT) or radiochemotherapy. The estimated 3-year local and pelvis relapse free survival for the entire population were respectively 98% [95% confidence interval, 89%-100%] and 90% [80%-96%]. The estimated 3-year disease-free survival (DFS) for the entire population was 88% [77-94%]. The 3-year overall survival (OS) rate was 97% [88%-99%]. Microscopic vaginal resection margin (R1) was observed in one patient ([1].4%). Lymph-vascular space invasion (LVSI) was found found in 6 (8.6%) patients. Forty-eight late complications in 36 patients (51.4%) were observed. Five (7.1%) grade 3 vaginal wound dehiscence toxicities were observed. Urinary and gastrointestinal toxicities were grade 1-2. No grade 4-5 complications were observed.Conclusions: Preoperative image-guided adaptive brachytherapy followed by minimally invasive surgery allows high local control, reduces positive surgical margins and rates of lymph-vascular space invasion avoiding adjuvants treatments. Surgical approaches must be discussed with patients including preoperative brachytherapy as a down-staging treatment. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0090-8258 1095-6859 |
| DOI: | 10.1016/j.ygyno.2021.01.034⟩ |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5bba7c061ce5e68143280bfa34599fa5 https://www.hal.inserm.fr/inserm-03649584/document |
| Rights: | EMBARGO |
| رقم الانضمام: | edsair.doi.dedup.....5bba7c061ce5e68143280bfa34599fa5 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00908258 10956859 |
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| DOI: | 10.1016/j.ygyno.2021.01.034⟩ |