Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT)
Abstract: Purpose: To define prognostic factors associated with improved survival and local control for gynecologic cancer recurrences limited to the pelvis and para-aortic region using stereotactic body radiation therapy (SBRT).Methods: Between 2/2008 and 7/2014, 30 women (35 targets) with pelvic o...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2016-11-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fonc.2016.00249/full |
| _version_ | 1831774860854951936 |
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| author | Shaakir Hasan Anthony Ricco Kaylette Jenkins Rachelle Lanciano Alexandra Hanlon John Lamond Jun Yang Jing Feng Michael Good Joel Noumoff Luther Brady |
| author_facet | Shaakir Hasan Anthony Ricco Kaylette Jenkins Rachelle Lanciano Alexandra Hanlon John Lamond Jun Yang Jing Feng Michael Good Joel Noumoff Luther Brady |
| author_sort | Shaakir Hasan |
| collection | DOAJ |
| description | Abstract: Purpose: To define prognostic factors associated with improved survival and local control for gynecologic cancer recurrences limited to the pelvis and para-aortic region using stereotactic body radiation therapy (SBRT).Methods: Between 2/2008 and 7/2014, 30 women (35 targets) with pelvic or PA recurrence of endometrioid (n=12), cervical (n=11), ovarian (n=3), uterine serous (n=2) or carcinosarcoma (n=2) CA were treated with SBRT. Eleven recurrences were located in the central pelvis(CP), 11 along the pelvic sidewall(PSW), and 13 in the para-aortic (PA)region.Results: Five-year survival for all patients was 42% with a median survival of 43.4 months. Multivariate analysis revealed better performance status (PS) and smaller clincial tumor volume (CTV) were significant for improved survival (P<0.05). Local control at 3 years was 90% and 83% for women treated for PSW and PA recurrence compared with 40% for CP recurrence (P=0.02). Patients with cervical CA had no local failures after SBRT, compared to a 3-year LC of 82% for endometroid uterine CA and 33% for ovarian/non-endometroid uterine CA (P=0.02). Multivariate analysis revealed only endometroid uterine and cervical CA and PSW/PA recurrences were significant for improved local control (P<0.05).Conclusion: SBRT is a local therapy for recurrent gynecological malignancies in the pelvis and PA region with curative potential. SBRT is especially effective for LC when targeting PSW or PA recurrence and for patients with a cervical/endometroid uterine primary. Survival is improved for patients with better PS and smaller recurrence volume prior to SBRT. |
| first_indexed | 2024-12-22T09:03:25Z |
| format | Article |
| id | doaj.art-c064b843e3264495b62908b158c2bc47 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-22T09:03:25Z |
| publishDate | 2016-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-c064b843e3264495b62908b158c2bc472022-12-21T18:31:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2016-11-01610.3389/fonc.2016.00249225776Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT)Shaakir Hasan0Anthony Ricco1Kaylette Jenkins2Rachelle Lanciano3Alexandra Hanlon4John Lamond5Jun Yang6Jing Feng7Michael Good8Joel Noumoff9Luther Brady10Philadelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemUniversity of Pennsylvania School of NursingPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemPhiladelphia Cyberknife / Crozer-Keystone Healthcare SystemAbstract: Purpose: To define prognostic factors associated with improved survival and local control for gynecologic cancer recurrences limited to the pelvis and para-aortic region using stereotactic body radiation therapy (SBRT).Methods: Between 2/2008 and 7/2014, 30 women (35 targets) with pelvic or PA recurrence of endometrioid (n=12), cervical (n=11), ovarian (n=3), uterine serous (n=2) or carcinosarcoma (n=2) CA were treated with SBRT. Eleven recurrences were located in the central pelvis(CP), 11 along the pelvic sidewall(PSW), and 13 in the para-aortic (PA)region.Results: Five-year survival for all patients was 42% with a median survival of 43.4 months. Multivariate analysis revealed better performance status (PS) and smaller clincial tumor volume (CTV) were significant for improved survival (P<0.05). Local control at 3 years was 90% and 83% for women treated for PSW and PA recurrence compared with 40% for CP recurrence (P=0.02). Patients with cervical CA had no local failures after SBRT, compared to a 3-year LC of 82% for endometroid uterine CA and 33% for ovarian/non-endometroid uterine CA (P=0.02). Multivariate analysis revealed only endometroid uterine and cervical CA and PSW/PA recurrences were significant for improved local control (P<0.05).Conclusion: SBRT is a local therapy for recurrent gynecological malignancies in the pelvis and PA region with curative potential. SBRT is especially effective for LC when targeting PSW or PA recurrence and for patients with a cervical/endometroid uterine primary. Survival is improved for patients with better PS and smaller recurrence volume prior to SBRT.http://journal.frontiersin.org/Journal/10.3389/fonc.2016.00249/fullEndometrial NeoplasmsOvarian NeoplasmsUterine Cervical NeoplasmsUterine NeoplasmsSBRTstereotactic body radiation therapy |
| spellingShingle | Shaakir Hasan Anthony Ricco Kaylette Jenkins Rachelle Lanciano Alexandra Hanlon John Lamond Jun Yang Jing Feng Michael Good Joel Noumoff Luther Brady Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT) Frontiers in Oncology Endometrial Neoplasms Ovarian Neoplasms Uterine Cervical Neoplasms Uterine Neoplasms SBRT stereotactic body radiation therapy |
| title | Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT) |
| title_full | Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT) |
| title_fullStr | Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT) |
| title_full_unstemmed | Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT) |
| title_short | Survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para-aortic region treated with stereotactic body radiation therapy (SBRT) |
| title_sort | survival and control prognosticators of recurrent gynecological malignancies of the pelvis and para aortic region treated with stereotactic body radiation therapy sbrt |
| topic | Endometrial Neoplasms Ovarian Neoplasms Uterine Cervical Neoplasms Uterine Neoplasms SBRT stereotactic body radiation therapy |
| url | http://journal.frontiersin.org/Journal/10.3389/fonc.2016.00249/full |
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