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000177263 041__ $$aEnglish
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000177263 1001_ $$00000-0001-7087-9581$$aMeixner, Eva$$b0
000177263 245__ $$aVaginal cancer treated with curative radiotherapy with or without concomitant chemotherapy: oncologic outcomes and prognostic factors.
000177263 260__ $$aThousand Oaks, Calif.$$bSage Publishing$$c2023
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000177263 500__ $$a2023 Feb;109(1):112-120
000177263 520__ $$aVaginal cancer is a rare disease for which prospective randomized trials do not exist. We aimed to assess survival outcomes, patterns of recurrence, prognostic factors, and toxicity in the curative treatment using image-guided radiotherapy (RT).In this retrospective review, we identified 53 patients who were treated at a single center with external beam radiotherapy and brachytherapy with or without concomitant chemotherapy from 2000 to 2021.With a median follow-up of 64.5 months, the Kaplan-Meier 2-, 5-, and 7-year overall survival (OS) was found to be 74.8%, 62.8%, and 58.9%, respectively. Local and distant control were 67.8%, 65.0%, and 65.0% and 74.4%, 62.6%, and 62.6% at 2, 5, and 7 years, respectively. In univariate Cox proportional hazards ratio analysis, OS was significantly correlated to FIGO stage (hazard ratio [HR] 1.78, p = 0.042), postoperative RT (HR 0.41, p = 0.044), and concomitant chemotherapy (HR 0.31, p = 0.009). Local control rates were superior when an equivalent dose in 2-Gy fractions (EQD2) of ⩾65 Gy was delivered (HR 0.216, p = 0.028) and with the use of concurrent chemotherapy (HR 0.248, p = 0.011). Not surprisingly, local control was inferior for patients with a higher TNM stage (HR 3.303, p = 0.027). Minimal toxicity was observed with no patients having documentation of high-grade toxicity (CTCAE grade 3+).In treatment of vaginal cancer, high-dose RT in combination with brachytherapy is well tolerated and results in effective local control rates, which significantly improve with an EQD2(α/β=10) ⩾65 Gy. Multivariate analyses revealed concomitant chemotherapy was a positive prognostic factor for overall and progression-free survival.
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000177263 650_7 $$2Other$$aSquamous cell carcinoma of the vagina
000177263 650_7 $$2Other$$acarbon ions
000177263 650_7 $$2Other$$ahigh-dose-rate brachytherapy
000177263 650_7 $$2Other$$avaginal neoplasms
000177263 7001_ $$aArians, Nathalie$$b1
000177263 7001_ $$aBougatf, Nina$$b2
000177263 7001_ $$aHoeltgen, Line$$b3
000177263 7001_ $$aKönig, Laila$$b4
000177263 7001_ $$00000-0002-5355-3173$$aLang, Kristin$$b5
000177263 7001_ $$aDomschke, Christoph$$b6
000177263 7001_ $$aWallwiener, Markus$$b7
000177263 7001_ $$aLischalk, Jonathan W$$b8
000177263 7001_ $$aKommoss, Felix K F$$b9
000177263 7001_ $$0P:(DE-He78)8714da4e45acfa36ce87c291443a9218$$aDebus, Jürgen$$b10$$udkfz
000177263 7001_ $$aHörner-Rieber, Juliane$$b11
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