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Titolo:
Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers
Autore:
Gemignani, ML; Alektiar, KM; Leitao, M; Mychalczak, B; Chi, D; Venkatraman, E; Barakat, RR; Curtin, JP;
Indirizzi:
Mem Sloan Kettering Canc Ctr, Gynecol Serv, Acad Off, Dept Surg, New York,NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York,NY 10021 USA Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Dept Biostat & Epidemiol, New York, NY 10021USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021USA NYU, Med Ctr, Dept Obstet & Gynaecol, Div Gynecol Oncol, New York, NY USA NYU New York NY USA stet & Gynaecol, Div Gynecol Oncol, New York, NY USA
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 3, volume: 50, anno: 2001,
pagine: 687 - 694
SICI:
0360-3016(20010701)50:3<687:RSRAHI>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
PELVIC EXENTERATION; CERVICAL-CANCER; UTERINE CERVIX; EXPERIENCE; CARCINOMA; MALIGNANCIES; IRRADIATION; SALVAGE;
Keywords:
high-dose-rate brachytherapy; IORT; gynecological cancer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
31
Recensione:
Indirizzi per estratti:
Indirizzo: Gemignani, ML Mem Sloan Kettering Canc Ctr, Gynecol Serv, Acad Off, Dept Surg, 1275 YorkAve,Room MRI-1027, New York, NY 10021 USA Mem Sloan KetteringCanc Ctr 1275 York Ave,Room MRI-1027 New York NY USA 10021
Citazione:
M.L. Gemignani et al., "Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers", INT J RAD O, 50(3), 2001, pp. 687-694

Abstract

Objective: To determine the outcome for patients with recurrent gynecologic tumors treated with radical resection and combined high-dose intraoperative radiation therapy (HDR-IORT). Methods and Materials: Between November 1993 and June 1998, 17 patients with recurrent gynecologic malignancies underwent radical surgical resection and high-dose-rate brachytherapy, The mean age of the study group was 49 years (range 28-72 years). The site of the primary tumor was the cervix in 9 (53%) patients, the uterus in 7 (41%) patients, and the vagina in 1 (60%) patient, The treatment for the primary disease was surgery with or without adjuvant radiation in 14 (82%)patients and definitive radiation in 3 (18%) patients, The current surgery consisted of exenterative surgery in 10 (59%) patients and tumor resection in 7 (41%) patients, Complete gross resection was achieved in 13 (76%) patients. The mean HDR-IORT dose was 14 Gy (range 12-15), Additional radiation in the form of permanent Iodine-125 implant was given to 3 of I patients with gross residual disease. The median peripheral dose was 140 Gy. Results: With a median follow-up of 20 months (range 3-65 months), the 3-year actuarial local control (LC) rate was 67%, In patients with complete gross resection, the 3-gear LC rate was 83%, compared to 25% in patients withgross residual disease, p < 0,01, The 3-year distant metastasis disease-free and overall survival rates were 54% and 54%, respectively. The complications were as follows: gastrointestinal obstruction, 4 (24%,); wound complications, 4 (24%); abscesses, 3 (18%); peripheral neuropathy, 3 (18%); rectovaginal fistula, 2 (12%); and ureteral obstruction, 2 (12%). Conclusion: Radical surgical resection and combined IORT for patients withrecurrent gynecologic tumors seems to provide a reasonable local-control rate in patients who have failed prior surgery and/or definitive radiation. Patient selection is very important, however, as only those patients with complete gross resection at completion of surgery appear to benefit most from this radical approach in the salvage setting. (C) 2001 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 12:07:39