Impact of Vaginal Dilator Use and 68 Gy EQD2(α/β=3) Dose Constraint on Vaginal Complications in External Beam Irradiation Followed by Brachytherapy in Post-Operative Endometrial Cancer
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All | Group-1 | Group-2 | p-Value | N | |
---|---|---|---|---|---|
N = 131 | N = 65 | N = 66 | |||
Mean Age (SD) | 65.4 (10.3) | 64.5 (10.3) | 66.4 (10.4) | 0.289 | 131 |
Histologic grade (n, (%)) | 0.032 | 131 | |||
G1 + 2 | 85 (65.9%) | 48 (73.8%) | 37 (56.1%) | ||
G3 | 46 (35.1%) | 17 (26.2%) | 29 (43.9%) | ||
Myometrial invasion (n, (%)) | 0.542 | 131 | |||
<50% | 48 (36.6%) | 26 (40.0%) | 22 (33.3%) | ||
≥50% | 83 (63.4%) | 39 (60.0%) | 44 (66.7%) | ||
Mean Tumor size (mm) (SD) | 38.4 (16.2) | 35.4 (15.5) | 41 (16.4) | 0.064 | 115 |
Focal LVSI (n, (%)) | <0.001 | 128 | |||
No | 64 (50.0%) | 44 (69.8%) | 20 (30.8%) | ||
Yes | 64 (50.0%) | 19 (30.2%) | 45 (69.2%) | ||
Pathologic types (n, (%)) | 0.917 | 131 | |||
Endometrioid | 98 (74.8%) | 49 (75.4%) | 49 (74.2%) | ||
Serous | 13 (9.9%) | 6 (9.2%) | 7 (10.6%) | ||
Clear cell | 6 (4.6%) | 2 (3.1%) | 4 (6.1%) | ||
Mix | 14 (10.7%) | 8 (12.3%) | 6 (9.1%) | ||
FIGO 2023 staging: (n, %) | 0.405 | 131 | |||
IA | 12 (9.2%) | 8 (12.3%) | 4 (6.1%) | ||
IB | 38 (29%) | 22 (33.8%) | 16 (24.2%) | ||
IC | 7 (5.3%) | 2 (3.1%) | 5 (7.6%) | ||
IIA | 12 (9.2%) | 5 (7.7%) | 7 (10.6%) | ||
IIB | 9 (6.9%) | 3 (4.6%) | 6 (9.1%) | ||
IIC | 2 (1.5%) | 0 (0.0%) | 2 (3%) | ||
IIIA | 7 (5.3%) | 4 (6.2%) | 3 (4.5%) | ||
IIIB | 2 (1.5%) | 1 (1.5%) | 1 (1.5%) | ||
IIIC | 17 (13%) | 8 (12.3%) | 9 (13.6%) | ||
IVA | 15 (11.5%) | 5 (7.7%) | 10 (15.2%) | ||
IVB | 3 (2.3%) | 3 (4.6%) | 0 (0.0%) | ||
IVC | 7 (5.3%) | 4 (6.2%) | 3 (4.6%) | ||
Chemotherapy (n, (%)) | 0.646 | 131 | |||
No | 77 (58.8%) | 40 (61.5%) | 37 (56.1%) | ||
Yes | 54 (41.2%) | 25 (38.5%) | 29 (43.9%) |
All | Group-1 | Group-2 | p-Value | N | |
---|---|---|---|---|---|
Applicator diameter (cm) | 0.219 | 131 | |||
2 | 2 (1.5%) | 0 (0.0%) | 2 (3.1%) | ||
2.5 | 11 (8.4%) | 3 (4.6%) | 8 (12.1%) | ||
3 | 19 (14.5%) | 10 (15.4%) | 9 (13.6%) | ||
3.5 | 99 (75.6%) | 52 (80.0%) | 47 (71.2%) | ||
Vaginal dilator use (n, (%)) | 0.011 | 131 | |||
<9 months | 97 (74.0%) | 55 (84.6%) | 42 (63.6%) | ||
≥9 months | 34 (26.0%) | 10 (15.4%) | 24 (36.4%) | ||
LVC (n, (%)) | 0.003 | 131 | |||
No | 78 (59.5%) | 29 (44.6%) | 49 (74.2%) | ||
Grade I | 43 (32.8%) | 29 (44.6%) | 14 (21.2%) | ||
Grade II | 10 (7.7%) | 7 (10.8%) | 3 (4.6%) | ||
Mean CTV (SD) | 8 (1.4) | 8.05 (1.5) | 7.92 (1.3) | 0.623 | 117 |
Mean dose per fraction (SD) | 6.7 (0.3) | 7.0 (0.0) | 6.5 (0.3) | <0.001 | 131 |
Mean D90 (SD) | 7.6 (0.7) | 7.9 (0.6) | 7.3 (0.6) | <0.001 | 129 |
Mean Overall EQD2(α/β=3) at 2 cm3 of CTV (SD) * | 69.1 (4.2) | 72.1 (3.1) | 66.1 (2.6) | <0.001 | 131 |
Mean EQD2(α/β=3) 2 cm3 of bladder (SD) | 9.8 (2.5) | 10.6 (2.2) | 8.6 (2.5) | <0.001 | 110 |
Mean EQD2(α/β=3) 2 cm3 of rectum (SD) | 9.6 (3.0) | 10.2 (2.2) | 8.9 (3.7) | <0.001 | 110 |
All | G0 | G1–2 | HR [95% CI] | p-Value | N | |
---|---|---|---|---|---|---|
N = 131 | N = 78 | N = 53 | ||||
Study group (n, (%)): | 0.005 | 131 | ||||
1 | 65 (49.6%) | 29 (37.2%) | 36 (67.9%) | 2.24 [1.26;3.99] | ||
2 | 66 (50.4%) | 49 (62.8%) | 17 (32.1%) | Ref. | ||
Age (Mean, (SD)) (year): | 65.4 (10.3) | 66.9 (9.7) | 63.3 (10.9) | 0.99 [0.96;1.01] | 0.275 | 131 |
Chemotherapy: | 0.167 | 131 | ||||
No | 77 (58.8%) | 50 (64.1%) | 27 (50.9%) | Ref. | ||
Yes | 54 (41.2%) | 28 (35.9%) | 26 (49.1%) | 1.46 [0.85;2.50] | ||
Applicator diameter (cm) | 0.955 | 131 | ||||
2 | 2 (1.5%) | 1 (1.3%) | 1 (1.9%) | Ref. | ||
2.5 | 11 (8.4%) | 6 (7.7%) | 5 (9.4%) | 0.70 [0.08;6.03] | ||
3 | 19 (14.5%) | 12 (15.4%) | 7 (13.2%) | 0.61 [0.07;4.95] | ||
3.5 | 99 (75.6%) | 59 (75.6%) | 40 (75.5%) | 0.73 [0.10;5.35] | ||
Vaginal dilator use (n, (%)) | 0.002 | 131 | ||||
<9 months | 97 (74.0%) | 50 (64.1%) | 47 (88.7%) | 3.44 [1.47;8.06] | ||
≥9 months | 34 (26.0%) | 28 (35.9%) | 6 (11.3%) | Ref. | ||
Mean dose per fraction (SD) | 6.7 (0.3) | 6.6 (0.3) | 6.9 (0.3) | 5.27 [1.73;16.1] | 0.003 | 131 |
Characteristic | HR | 95% CI | p-Value |
---|---|---|---|
Group | |||
1 | 1.99 | 1.11, 3.55 | 0.021 |
2 | — | — | |
Vaginal dilator use | |||
<9 months | 3.07 | 1.30, 7.23 | 0.010 |
≥9 months | — | — |
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Noorian, F.; Abellana, R.; Zhang, Y.; Herreros, A.; Lancellotta, V.; Tagliaferri, L.; Sabater, S.; Torne, A.; Agusti-Camprubi, E.; Rovirosa, A. Impact of Vaginal Dilator Use and 68 Gy EQD2(α/β=3) Dose Constraint on Vaginal Complications in External Beam Irradiation Followed by Brachytherapy in Post-Operative Endometrial Cancer. J. Pers. Med. 2024, 14, 838. https://doi.org/10.3390/jpm14080838
Noorian F, Abellana R, Zhang Y, Herreros A, Lancellotta V, Tagliaferri L, Sabater S, Torne A, Agusti-Camprubi E, Rovirosa A. Impact of Vaginal Dilator Use and 68 Gy EQD2(α/β=3) Dose Constraint on Vaginal Complications in External Beam Irradiation Followed by Brachytherapy in Post-Operative Endometrial Cancer. Journal of Personalized Medicine. 2024; 14(8):838. https://doi.org/10.3390/jpm14080838
Chicago/Turabian StyleNoorian, Faegheh, Rosa Abellana, Yaowen Zhang, Antonio Herreros, Valentina Lancellotta, Luca Tagliaferri, Sebastià Sabater, Aureli Torne, Eduard Agusti-Camprubi, and Angeles Rovirosa. 2024. "Impact of Vaginal Dilator Use and 68 Gy EQD2(α/β=3) Dose Constraint on Vaginal Complications in External Beam Irradiation Followed by Brachytherapy in Post-Operative Endometrial Cancer" Journal of Personalized Medicine 14, no. 8: 838. https://doi.org/10.3390/jpm14080838