Impact of vaginal dilators in G2-late vaginal complications in brachytherapy for endometrial cancer.
PD-0412
Abstract
Impact of vaginal dilators in G2-late vaginal complications in brachytherapy for endometrial cancer.
Authors: Angeles Rovirosa1, Yaowen Zhang2, Faegheh Noorian1, Rosa Abellana3, Rochera José4, Antonio Herreros4, Gabriela Antelo4, Aureli Torne5
1Hospital Clinic-Universitat de Barcelona, Radiation Oncology, Barcelona, Spain; 2 Henan Provincial People’s Hospital. China, Cancer Center,, Zhengzhou, China; 3Hospital Clínic-Universitat de Barcelona, Fonaments Clínics, Barcelona, Spain; 4Hospital Clínic-Universitat de Barcelona, Radiation Oncology, Barcelona, Spain; 5Hospital Clínic-Universitat de Barcelona, Gynecological cancer Unit, Barcelona, Spain
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Purpose or Objective
To evaluate possible prognostic factors for G2-late vaginal complications after vaginal brachytherapy (VBT) with or without external beam radiotherapy in postoperative endometrial cancer (PEC).
Material and Methods
Between 2013 and 2018, 126 PEC patients treated with VBT±EBRT were retrospectively analysed considering possible prognostic factors for vaginal complications including age, body mass index, applicator diameter, clinical target volume (CTV), use of dilators, chemotherapy and EQD2(α/β=3) at the most exposed 2cm3 of the vagina. Late vaginal complications were evaluated using objective criteria of LENT-SOMA. Statistical analysis: The Chi-square or Fisher exact test and Student’s test were used to study the association between G2 late vaginal complications and prognostic factors. The variables associated at a univariate level were considered in the multiple logistic regression model.
Results
The median age was 66 years (40-86), and the median follow-up was 66 months (8-104). Among 126 patients, no one showed vaginal-cup relapse in the present series but one in the outer third. 19/126 (15%) showed G2 late vaginal complications, and 107/126 patients G0-G1. In the univariate analysis CTV ≤ 9cm3 (p=0.036), use of dilators <9 months (p=0.015), and total EQD2 received by 2cm3 of the most exposed to the dose CTV ≥68Gy (p=0.039) were associated with G2 late vaginal toxicity. Multivariate analysis showed the use of vaginal dilators >9 months as the only independent prognostic factor for reducing G2-late vaginal toxicity (OR=8.59;95% CI: 1.59-159.9 and p=0.043,).
Conclusion
The present cohort study showed the use of vaginal dilators >9 months to be an independent prognostic factor in reducing G2-late vaginal toxicity in multivariate analysis. The use of vaginal dilators >9 months should be better analysed in the future and considered in studies analysing brachytherapy related vaginal toxicity.