Image-Guided Radiotherapy and Chemotherapy in Gynaecological Cancer

Randomized trials ”radiographic-era”

Author (ref) acrual period

Vaginal recurrence

Locoregional recurrence

No. patients, eligibility

Treatment

Survival

Severe complications

Randomized trial VBT versus NAT in low risk endometrial cancer

Sorbe et al. 47

645; Stage 1A grade 1-23 to 6 x 3 to 8 Gy

1,2% 2,6% 96% OS at 5-years no grade 3/4

1995-2004

at 0.5 cm vs. NAT

3,1%

Randomized trials VBT versus EBRT +/- VBT in (high) intermediate risk endometrial cancer

Norwegian 1 1968–1974

1 x 60 Gy LDR at surf vs. EBRT + same VBT

6,9% 91% OS at 5-years 1% grade 4 1,9% 89% OS at 5-years 1.1% grade 4/5

540; Stage I

PORTEC-2

427, age >60 IA grade 3x 7Gy at 0.5 cm vs.

1,8% 5,1% 85% OS at 5-years

GI: VBT 0.5% vs 1.9%

2002–2006 IB grade 1–2 (HIR) EBRT

1,6% 2,1% 80% OS at 5-years Vagina: 1.9% vs 0.5%

Swedish 7

527; Stage I and 6 x 3 Gy at 0.5 cm 2.7% *

5,0% 90% OS at 5-years grd 3 VBT vs EBRT + VBT

1997-2008 (grade 3 or deep invasion3 x 5.9 Gy at 0.5 cm

GI: 0% vs 2%

or DNA aneuploidy) and1 x 20 Gy LDR at 0.5 cm nuclear grade 1-2 vs. EBRT + same VBT 1.9% *

Vagina: 0.8% vs 0%

1,5% 89% OS at 5-years

• Different dose/fractionation & prescription • Treated lengths range proximal 1/3 – 1/2 (3-5cm) • All seem effective