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Vienna, Austria

ESTRO 2023

Session Item

Sunday
May 14
09:00 - 10:00
Business Suite 3-4
Clinical Brachytherapy
Alina Sturdza, Austria
Poster Discussion
Brachytherapy
Radio-chemotherapy and interventional radiotherapy in vaginal carcinoma: a monocentric experience
Valentina Lancellotta, Italy
PD-0409

Abstract

Radio-chemotherapy and interventional radiotherapy in vaginal carcinoma: a monocentric experience
Authors:

Valentina Lancellotta1, Gabriella Macchia2, Bruno Fionda1, Rosa Autorino1, Maura Campitelli1, Martina De Angeli3, Giorgia Garganese4, Benedetta Gui5, Luca Russo6, Simona Fragomeni7, Gabriella Ferrandina8, Maria Antonietta Gambacorta1, Luca Tagliaferri1

1Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; 2Gemelli Molise Hospital – Università Cattolica del Sacro Cuore, Radiation Oncology Unit, Campobasso, Italy; 3Università di Roma, Tor Vergata, Radiation Oncology, Rome, Italy; 4Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Department of Medicine and Health Sciences, Rome, Italy; 5Fondazione Policlinico Universitario A. Gemelli IRCCS, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; 6Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy; 7Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Department of Medicine and Health Sciences, Rome, Italy; 8Department of Medicine and Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

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Purpose or Objective

Vaginal carcinoma (VC) is a rare malignancy accounting for 1% to 2% of all gynaecologic cancers. Although surgery yields good local control (LC) and overall survival (OS) in selected cases of vaginal intraepithelial neoplasms and early (I–II) stages of VC, definitive radio-chemotherapy (RCT) followed by interventional radiotherapy (IRT, also called brachytherapy, BT) is considered an excellent option. The aim of this study was to report the results of our mono-institutional series of vaginal cancer patients treated with radio-chemotherapy followed by image- guided IRT.

Material and Methods

We retrospectively analysed 16 patients with primary vaginal cancer who received RCT followed by IRT with curative intent between January 2019 and December 2021. OncentraBrachy treatment planning system and a Flexitron (Elekta, Stockholm, Sweden) device with a 192-Ir source were used for IRT treatment. The primary study endpoint was the local control (LC), secondary endpoints were the overall survival (OS), the cancer specific survival (CSS), disease free survival (DFS) and the rate and severity of acute and late toxicities.

Results

All patients received planned treatment. Twelve patients were stage II, 2 patients’ stage III and 2 stage IVB (International Federation of Gynecology and Obstetrics stages 2008). The median total dose of external beam RT was 45Gy (range 45Gy-60Gy). The IRT total dose was 28 Gy. All patients received weekly cisplatin chemotherapy. The median duration of follow-up was 19 months (6-38 months). One-year LC, OS, CSS and DFS rates were 100%, 100%, 100%, 92.8%, respectively. Acute toxicity was registered in 10 cases. There were five gastro/genitourinary G1, four gastrointestinal G2, one genito-urinary G2, three vaginal inflammatory G2. Late toxicity was reported in ten cases: 6 G1 stenoses, 2 G2 stenoses, and 1 G3 stenosis. Teleangectasia G1 was identified in one case.



Conclusion

The combination of definitive RCT with image-guided IRT is a successful therapeutic option for primary vaginal cancer with a manageable level of toxicity.