Image-guided adaptive brachytherapy (Igabt) for primary vaginal cancer: Results of the international multicenter retroembrave cohort study

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  • Henrike Westerveld, University of Amsterdam
  • ,
  • Maximilian P. Schmid, Medical University of Vienna
  • ,
  • Remi A. Nout, Leiden University, Erasmus University Rotterdam
  • ,
  • Cyrus Chargari, Universite Paris-Saclay
  • ,
  • Bradley R. Pieters, University of Amsterdam
  • ,
  • Carien L. Creutzberg, Leiden University
  • ,
  • Alina Sturdza, Medical University of Vienna
  • ,
  • Jacob C. Lindegaard
  • Zdenko van Kesteren, University of Amsterdam
  • ,
  • Renaud Mazeron, Universite Paris-Saclay
  • ,
  • Nicole Nesvacil, Medical University of Vienna
  • ,
  • Lars U. Fokdal

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.

Original languageEnglish
Article number1459
Number of pages15
Publication statusPublished - 2 Mar 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

    Research areas

  • Brachytherapy, IGABT, Image-guided brachytherapy, MRI, Radiotherapy, RetroEMBRAVE, Vaginal can-cer

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