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Master Thesis

Curiethérapie utéro-vaginale à haut debit de dose dans le cancer du col localement avancé : résultats oncologiques et toxicités de quatre fractionnements

Abstract : Purpose: brachytherapy (BT) boost after radio-chemotherapy (RCT) is a standard of care treatment in the management of locally advanced cervical cancer (LACC). As there is no consensus on high-dose-rate (HDR) BT fractionation schemes, our aim was to report the oncological outcome and toxicity profile of four different schemes using bi-fractionated HDR-BT.
Patients and methods: this was an observational retrospective single institution study for patients with LACC receiving a HDR-BT boost. The latter was performed with a single implant and single imaging done the first day. The different fractionation schemes were: 7 Gy+4x3.5Gy (group 1); 7 Gy+4x4.5Gy (group 2); 3x7Gy (group 3) and 3x8Gy (group 4). Local (LFS), nodal (NFS) and metastatic (MFS) recurrence-free survival, progression-free survival (PFS) and overall survival (OS) were analyzed. Acute (≤ 6 months) and late toxicities (> 6 months) were also reported.
Results: from 2007 to 2018, 191 patients were included. Median follow up was 57 months (45-132) and median EQD210 D90CTVHR were 84, 82 and 90 Gy for groups 2, 3 and 4 respectively (dosimetric data missing for group 1). The 5-year LFS, NFS, MFS, PFS and OS were 85% (81-90%), 83% (79-86%), 70% (67-73%), 61% (57-64%) and 75% (69-78%) respectively, with no significant difference between the groups. EQD210D90CTVHR<85Gy was a prognostic factor for local recurrence in univariate analysis (p=0.045). The rates of acute/late grade ≥2 urinary, digestive and gynecological toxicities were 9%/15%, 3%/15% and 9%/25% respectively.
Conclusion: bi-fractionated HDR-BT boost seems feasible with good oncological outcome and slightly more toxicity after dose escalation.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03369940
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Submitted on : Thursday, October 7, 2021 - 4:29:17 PM
Last modification on : Tuesday, December 7, 2021 - 4:10:59 PM
Long-term archiving on: : Saturday, January 8, 2022 - 7:32:24 PM

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2021NICEM067.pdf
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  • HAL Id : dumas-03369940, version 1

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Maud Le Guyader. Curiethérapie utéro-vaginale à haut debit de dose dans le cancer du col localement avancé : résultats oncologiques et toxicités de quatre fractionnements. Médecine humaine et pathologie. 2021. ⟨dumas-03369940⟩

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