title: Radiation therapy complications in patients with primary invasive vaginal carcinoma.
abstract: OBJECTIVE
  The aim of the study was to estimate acute and late complications of radiation therapy in primary invasive vaginal carcinoma (PIVC) patients.
  
  
  METHODS
  The analysis was performed for the group of 152 PIVC patients given radical radiotherapy in the Krakow Branch of Centre of Oncology during the 1967-2005 period. Twenty five (16.5%) patients in I stage with primary tumour of the thickness not larger than 0.5 cm were treated with intracavitary brachytherapy alone, for 120 (78.9%) patients (stages I-IVA) intracavitary brachytherapy was combined with external radiation therapy; and 7 (4.6%) patients in stage IVA were given only external radiotherapy In total, 145 (95.4%) patients were treated with intracavitary LDR brachyterapy by means of Ra-226 or afterloaded Cs-137 sources, and 127 (83.5%) received external radiation therapy using Co-60 and linac 10MV or 6MV photon beams.
  
  
  RESULTS
  Early radiotherapy tolerance was good in the investigated group; 146 (96.1%) patients completed full planned radiation therapy treatment. Late complications of radiation therapy were observed in 21 (13.8%) patients: 3 (2%) patients reported mild complications, 12 (7.9%) moderate complications, and 6 (3.9%) severe complications. Severe complications of radiation therapy in the investigated group included: recto-vaginal fistula (5 patients) and vesico-vaginal fistula (1 patient). None of the patients in the group died of radiation therapy complications.
  
  
  CONCLUSIONS
  Early tolerance of radiotherapy in PIVC patients is generally good. Late radiation therapy complications, particularly the severe, are rare and can be efficiently managed with conservative therapy or surgical treatment.
authors.affiliation: Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Krakow Branch, Poland. pawel.blecharz@interia.pl
authors.forename: Paweł
authors.initials: P
authors.lastname: Blecharz
authors.forename: Marian
authors.initials: M
authors.lastname: Reinfuss
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jakubowicz
authors.forename: Piotr
authors.initials: P
authors.lastname: Skotnicki
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Łuczyńska
authors.forename: Maciej
authors.initials: M
authors.lastname: Bodzek
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Urbański
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000706:statistics & numerical data; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011044:Poland; D011832:Radiation Injuries / Q000453:epidemiology*; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D016387:Women's Health