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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 2/2014

01-02-2014 | Original article

External-beam radiation therapy after surgical resection and intraoperative electron-beam radiation therapy for oligorecurrent gynecological cancer

Long-term outcome

Authors: C.V. Sole, M.D., F.A. Calvo, M.D., Ph.D., M.A. Lozano, M.D., L. Gonzalez-Bayon, M.D., Ph.D., C. Gonzalez-Sansegundo, M.D., A. Alvarez, M.D., S. Lizarraga, M.D., J.L. García-Sabrido, M.D., Ph.D.

Published in: Strahlentherapie und Onkologie | Issue 2/2014

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Abstract

Purpose

The goal of the present study was to analyze prognostic factors in patients treated with external-beam radiation therapy (EBRT), surgical resection and intraoperative electron-beam radiotherapy (IOERT) for oligorecurrent gynecological cancer (ORGC).

Patients and methods

From January 1995 to December 2012, 61 patients with ORGC [uterine cervix (52 %), endometrial (30 %), ovarian (15 %), vagina (3 %)] underwent IOERT (12.5 Gy, range 10–15 Gy), and surgical resection to the pelvic (57 %) and paraaortic (43 %) recurrence tumor bed. In addition, 29 patients (48 %) also received EBRT (range 30.6–50.4 Gy). Survival outcomes were estimated using the Kaplan–Meier method, and risk factors were identified by univariate and multivariate analyses.

Results

Median follow-up time for the entire cohort of patients was 42 months (range 2–169 months). The 10-year rates for overall survival (OS) and locoregional control (LRC) were 17 and 65 %, respectively. On multivariate analysis, no tumor fragmentation (HR 0.22; p = 0.03), time interval from primary tumor diagnosis to locoregional recurrence (LRR) < 24 months (HR 4.02; p = 0.02) and no EBRT at the time of pelvic recurrence (HR 3.95; p = 0.02) retained significance with regard to LRR. Time interval from primary tumor to LRR < 24 months (HR 2.32; p = 0.02) and no EBRT at the time of pelvic recurrence (HR 3.77; p = 0.04) showed a significant association with OS after adjustment for other covariates.

Conclusion

External-beam radiation therapy at the time of pelvic recurrence, time interval for relapse ≥ 24 months and not multi-involved fragmented resection specimens are associated with improved LRC in patients with ORGC. As suggested from the present analysis a significant group of ORGC patients could potentially benefit from multimodality rescue treatment.
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Metadata
Title
External-beam radiation therapy after surgical resection and intraoperative electron-beam radiation therapy for oligorecurrent gynecological cancer
Long-term outcome
Authors
C.V. Sole, M.D.
F.A. Calvo, M.D., Ph.D.
M.A. Lozano, M.D.
L. Gonzalez-Bayon, M.D., Ph.D.
C. Gonzalez-Sansegundo, M.D.
A. Alvarez, M.D.
S. Lizarraga, M.D.
J.L. García-Sabrido, M.D., Ph.D.
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 2/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0472-5

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