title: High-dose-rate (HDR) brachytherapy with or without external beam radiotherapy in the treatment of primary vaginal carcinoma: long-term results and side effects.
abstract: OBJECTIVE
  To report toxicity, prognostic factors, and outcome of HDR brachytherapy in the primary management of vaginal carcinoma.
  
  
  METHODS
  A total of 86 patients receiving radiotherapy for primary vaginal carcinoma were analyzed. FIGO stages 0-IV were found in 6, 17, 38, 20, and 5 patients, respectively. Early stages of disease (Stages 0-II) were treated with intravaginal HDR brachytherapy alone (n = 26/86), whereas locally advanced diseases (Stages II-IV) received HDR brachytherapy combined with external beam therapy (n = 55/86). Teletherapy only was used in 5 of 86 cases, all of which were treated with palliative intent (i.e., advanced stage, poor general status). Recurrence-free intervals as well as overall- and disease-specific survival rates were determined for all patients. Frequencies of side effects and the influence of prognostic factors and treatment modalities on outcome were analyzed.
  
  
  RESULTS
  Five-year overall survival rates for Stages 0-IV diseases were 83%, 41%, 43%, 37%, and 0%, respectively. Corresponding 5-year disease-specific survival rates were 100%, 92%, 57%, 59%, and 0%. Regarding 5-year recurrence-free intervals, values of 100%, 77%, 50%, 23%, and 0% (Stages 0-IV) were found, respectively. Tumor stage was the most significant prognostic factor. Chronic side effects G 1-4 were observed in <or=2% (bladder, rectum) and 1%-6% (vagina).
  
  
  CONCLUSIONS
  In the treatment of primary vaginal carcinoma, HDR brachytherapy appeared to be well-tolerated and as effective as LDR brachytherapy techniques.
authors.affiliation: Department of Radiotherapy and Radiobiology, University Hospital Vienna, Vienna, Austria. ulrike.mock@str.akh.magwien.gv.at
authors.forename: Ulrike
authors.initials: U
authors.lastname: Mock
authors.forename: Herwig
authors.initials: H
authors.lastname: Kucera
authors.forename: Claudia
authors.initials: C
authors.lastname: Fellner
authors.forename: Thomas Hendrik
authors.initials: TH
authors.lastname: Knocke
authors.forename: Richard
authors.initials: R
authors.lastname: Pötter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000473:pathology / Q000532:radiotherapy*