Potent brachytherapy effective against vaginal cancer

March 4, 2008

NEW YORK (Reuters Health) - High-dose rate brachytherapy (HDRB) appears effective for many patients with primary or recurrent cancer of the vagina, according to Pennsylvania-based researchers.

In a February 13th publication by the BioMed Central journal Radiation Oncology, Dr. Sushil Beriwal, of the University of Pittsburgh Cancer Institute, and colleagues note that most investigators have evaluated low-dose rate brachytherapy.

To examine the utility of the high-dose rate approach, the team studied 6 patients with primary vaginal cancer and 12 with isolated vaginal recurrence from other primary gynecologic malignancies. Five had had previous pelvic radiation therapy.

Five patients with superficially invasive tumors received intracavitary brachytherapy using a vaginal cylinder (mean dose 20 Gy in 3-5 fractions), and the remaining 13 had an interstitial approach with a modified Syed-Nesblett template (18.75 Gy in 5 fractions).

A complete response was achieved in all but one patient. Among the 17 responders, one had local recurrence and three had systemic recurrence at a median of 6 months.

Two-year actuarial control for the whole group was 88%, and cause-specific survival was 82.5%. Crude local control was achieved in all of the primary vaginal cancer patients, and all with recurrence without prior radiation. For those with recurrence who had prior radiation therapy, the proportion was 67%.

Two patients, both of whom who had had prior radiation, had late grade 3 or greater morbidity.

The researchers concede that this retrospective study had shortcomings. However, they conclude, "Our small series with preliminary results shows that HDRB is efficacious for primary or recurrent vaginal cancer."