Purpose: This study assessed outcomes following the nowadays standing treatment for primary vaginal cancer with radio(chemo)therapy and image-guided adaptive brachytherapy (IGABT) in a multicenter patient cohort. Methods: Patients treated with computer tomography (CT)–MRI-assisted-based IGABT were included. Retrospective data collection included patient, tumor and treatment characteristics. Late morbidity was assessed by using the CTCAE 3.0 scale. Results: Five European centers included 148 consecutive patients, with a median age of 63 years. At a median follow-up of 29 months (IQR 25–57), two-and five-year local control were 86% and 83%; disease-free survival (DFS) was 73% and 66%, and overall survival (OS) was 79% and 68%, respectively. Crude incidences of ≥ grade-three urogenital, gastro-intestinal and vaginal morbidity was 8%, 3% and 8%, respectively. Lymph node metastasis was an independent prognostic factor for disease-free survival (DFS). Univariate analysis showed improved local control in patients with T2–T4 tumors if >80 Gy EQD2α/β10 was delivered to the clinical target volume (CTV) at the time of brachytherapy. Conclusions: In this large retrospective multicenter study, IGABT for primary vaginal cancer resulted in a high local control with acceptable morbidity. These results compared favorably with two-dimensional (2D) radiograph-based brachytherapy and illustrate that IGABT plays an important role in the treatment of vaginal cancer.
|Publication status||Published - 23 Mar 2021|
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Conflicts of Interest: Maximilian Schmid, Alina Sturdza, and Nicole Nesvacil receive personal grants from Elekta outside the submitted work. Remi Nout receives grants from Elekta, Varian Medical Systems and Accuray outside the submitted work. Cyrus Chargari receives personal grants and nonfinancial support from Takeda and MSD, service as an investigator for clinical trials sponsored by TherAgulX and Roche, and personal grants from Elekta outside the submitted work. Jacob Lindegard receives a personal grant from Varian Medical Systems outside the submitted work. The other authors declare no conflict of interest.
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