title: Clinical outcome of high-dose-rate interstitial brachytherapy in vulvar cancer: A single institutional experience.
abstract: With an aim to evaluate and report high dose date interstitial brachytherapy (HDR-ISBT) in vulvar cancers, we undertook this retrospective analysis.
  
  
  
  Histologically proven vulvar cancers treated with HDR-ISBT between 2001 and 2016 were analyzed. Radiotherapy details, clinical outcome in terms of local control rates, survivals, and toxicities were evaluated.
  
  
  
  A total of 38 patients received HDR-ISBT, with definitive radiation in 29 (76.3%), adjuvant postoperative in six (15.8%) and salvage radiation in three (7.9%) patients. Of them, 29 patients received brachytherapy boost and nine patients ISBT alone. BT procedure included freehand plastic tube technique in 23 (single [n = 5] or multiple plane [n = 18]), 13 patients with template based and two patients combined approach. Patients with brachytherapy alone received median EQD2 of 38.4 Gy10(35.5-46.7 Gy10), as boost received median 23.3 Gy10(13-37.3 Gy10). At 3-month post-treatment response evaluation, 30 patients achieved clinically complete response, two patients partial response and six maintained postoperative status. With a median follow-up of 30 months, 29 (76.3%) were disease free, and 9 (23.7%) patients had relapsed disease with four patients expired due to disease and two died of other causes. The 5-year overall survival, disease free survival, and local control rates were 82%, 51%, and 77%, respectively.
  
  
  
  HDR-ISBT in vulvar cancer is a feasible and a viable option with acceptable and comparable outcomes.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. Electronic address: drumeshm@gmail.com.
authors.forename: Umesh
authors.initials: U
authors.lastname: Mahantshetty
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Pushpa
authors.initials: P
authors.lastname: Naga
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Reena
authors.initials: R
authors.lastname: Engineer
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Supriya
authors.initials: S
authors.lastname: Sastri
authors.affiliation: Department of Medical Physics, Tata Memorial Hospital, Mumbai, India.
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Ghadi
authors.affiliation: Department of Medical Physics, Tata Memorial Hospital, Mumbai, India.
authors.forename: Udita
authors.initials: U
authors.lastname: Upreti
authors.affiliation: Department of Medical Physics, Tata Memorial Hospital, Mumbai, India.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Somesan
authors.affiliation: Department of Medical Physics, Tata Memorial Hospital, Mumbai, India.
authors.forename: Sudarshan
authors.initials: S
authors.lastname: Kadam
authors.affiliation: Department of Medical Physics, Tata Memorial Hospital, Mumbai, India.
authors.forename: Satish
authors.initials: S
authors.lastname: Kohle
authors.affiliation: Department of Medical Physics, Tata Memorial Hospital, Mumbai, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Deshpande
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
authors.forename: Shyam Kishore
authors.initials: SK
authors.lastname: Shrivastava
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome; D014846:Vulvar Neoplasms / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D007496:Iridium Radioisotopes
keywords: Clinical outcome; HDR; Interstitial brachytherapy; Toxicity; Vulvar cancer