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Master Thesis

Tumeurs urétrales et péri-urétrales de la femme traitée par curiethérapie

Abstract : Peri-urethral cancer (PUC) in females is a rare malignancy. Brachytherapy (BT), either alone or combined with radiation therapy, is a preferred treatment option to spare the morbidity of surgery and achieve organ preservation. We report, to our best knowledge, the largest experience of brachytherapy as part of the treatment of female vaginal PUC. Medical records of all consecutive female patients receiving BT between 1990 and 2018 as part of their treatment for a PUC were examined. Patients were treated with low-dose rate (LDR) or pulse-dose rate (PDR) BT, with or without external beam radiotherapy. Patients were treated with interstitial needles (freehand implantation) +/—a personalized vaginal mold applicator. Patterns of relapse as well as morbidity were examined. A total of 44 patients with PUC (22 primary and 22 recurrent) were identified. Most frequent histologies were adenocarcinoma (n = 20), squamous cell carcinoma (n = 14) and urothelial carcinoma (n = 5). A total of 24 patients were treated with BT alone and 20 patients were treated in combination with EBRT. The median prescribed dose was 20 Gy (IQ range: 15–56.25 Gy) when BT was used as single modality and 60 Gy (IQ range: 60 - 60 Gy) when combined with EBRT. With a median follow-up of 21.5 months (range 7.5–60.75), a total of six patients experienced local relapse (17.5%). Overall survival probability was 63% at 2 years in the whole cohort (95%CI : 49.2 – 81.4 %) Most common toxicities were patients acute genito-urinary grade 1–2 toxicities. At last follow-up, severe morbidities were as follows: four patients experienced focal necrosis. In this cohort of LDR/PDR BT for PUC, we observed a high probability of local control with acceptable morbidity. Survival was however poor, with high metastatic relapse probability.
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https://dumas.ccsd.cnrs.fr/dumas-03414636
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Submitted on : Thursday, November 4, 2021 - 3:26:38 PM
Last modification on : Tuesday, December 14, 2021 - 3:57:00 AM
Long-term archiving on: : Saturday, February 5, 2022 - 6:58:54 PM

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  • HAL Id : dumas-03414636, version 1

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Mickaël Andraud. Tumeurs urétrales et péri-urétrales de la femme traitée par curiethérapie. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03414636⟩

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