Intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy as adjuvant treatment for uterine papillary serous carcinoma and clear cell carcinoma

A phase II Hoosier Oncology Group (HOG 97-01) study

Achilles J. Fakiris, David H. Moore, Shailaja R. Reddy, Katherine Y. Look, Constantin Yiannoutsos, Marcus E. Randall, Higinia R. Cardenes

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective. A phase II study was conducted to evaluate the role of adjuvant intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy in patients with uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CCC), after complete surgical staging. Methods. Patients were required to have undergone complete surgical staging including maximal surgical resection. Residual ≤3 mm intraperitoneal disease, and pelvic and para-aortic lymph node dissection with negative nodes, were required. A dose of 15 mCi of intraperitoneal 32P was administered within 8 weeks of surgery. Vaginal brachytherapy was delivered using either high dose rate, total dose of 2100 cGy in 3 fractions (700 cGy per fraction prescribed to 0.5 cm depth from the vaginal surface) or low dose rate to 6500 cGy (prescribed to the vaginal surface) in 1-2 fractions. Results. For the 21 evaluable patients, distribution by FIGO stage was as follows: Stages I-IIB (17), Stages III-IV (4). The median follow-up was 39.6 months (range: 5-63 months). No patients experienced grade 2-4 complications from their adjuvant therapy. Five patients suffered a recurrence: intraperitoneal [n = 2], distal vaginal [n = 2], and one at the surgical scar. Following the 2 distal vagina recurrences early in the trial, the entire length of the vagina was treated with intracavitary brachytherapy. No additional vaginal recurrences were observed. The two-year overall survival, cause-specific survival, and disease-free survival for the entire series were 89.2%, 89.2%, and 79.7%, respectively. Conclusions. Adjuvant therapy for UPSC and CCC with intraperitoneal 32P and vaginal brachytherapy after comprehensive surgical staging is feasible, well tolerated, and warrants further study on a larger scale.

Original languageEnglish
Pages (from-to)818-823
Number of pages6
JournalGynecologic Oncology
Volume96
Issue number3
DOIs
StatePublished - Mar 2005

Fingerprint

Papillary Carcinoma
Brachytherapy
Phosphorus
Carcinoma
Vagina
Recurrence
Therapeutics
Survival
Lymph Node Excision
Disease-Free Survival
Cicatrix

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy as adjuvant treatment for uterine papillary serous carcinoma and clear cell carcinoma : A phase II Hoosier Oncology Group (HOG 97-01) study. / Fakiris, Achilles J.; Moore, David H.; Reddy, Shailaja R.; Look, Katherine Y.; Yiannoutsos, Constantin; Randall, Marcus E.; Cardenes, Higinia R.

In: Gynecologic Oncology, Vol. 96, No. 3, 03.2005, p. 818-823.

Research output: Contribution to journalArticle

@article{06724a1fd9254cccb93f530a866aca60,
title = "Intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy as adjuvant treatment for uterine papillary serous carcinoma and clear cell carcinoma: A phase II Hoosier Oncology Group (HOG 97-01) study",
abstract = "Objective. A phase II study was conducted to evaluate the role of adjuvant intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy in patients with uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CCC), after complete surgical staging. Methods. Patients were required to have undergone complete surgical staging including maximal surgical resection. Residual ≤3 mm intraperitoneal disease, and pelvic and para-aortic lymph node dissection with negative nodes, were required. A dose of 15 mCi of intraperitoneal 32P was administered within 8 weeks of surgery. Vaginal brachytherapy was delivered using either high dose rate, total dose of 2100 cGy in 3 fractions (700 cGy per fraction prescribed to 0.5 cm depth from the vaginal surface) or low dose rate to 6500 cGy (prescribed to the vaginal surface) in 1-2 fractions. Results. For the 21 evaluable patients, distribution by FIGO stage was as follows: Stages I-IIB (17), Stages III-IV (4). The median follow-up was 39.6 months (range: 5-63 months). No patients experienced grade 2-4 complications from their adjuvant therapy. Five patients suffered a recurrence: intraperitoneal [n = 2], distal vaginal [n = 2], and one at the surgical scar. Following the 2 distal vagina recurrences early in the trial, the entire length of the vagina was treated with intracavitary brachytherapy. No additional vaginal recurrences were observed. The two-year overall survival, cause-specific survival, and disease-free survival for the entire series were 89.2{\%}, 89.2{\%}, and 79.7{\%}, respectively. Conclusions. Adjuvant therapy for UPSC and CCC with intraperitoneal 32P and vaginal brachytherapy after comprehensive surgical staging is feasible, well tolerated, and warrants further study on a larger scale.",
author = "Fakiris, {Achilles J.} and Moore, {David H.} and Reddy, {Shailaja R.} and Look, {Katherine Y.} and Constantin Yiannoutsos and Randall, {Marcus E.} and Cardenes, {Higinia R.}",
year = "2005",
month = "3",
doi = "10.1016/j.ygyno.2004.11.050",
language = "English",
volume = "96",
pages = "818--823",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "3",

}

TY - JOUR

T1 - Intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy as adjuvant treatment for uterine papillary serous carcinoma and clear cell carcinoma

T2 - A phase II Hoosier Oncology Group (HOG 97-01) study

AU - Fakiris, Achilles J.

AU - Moore, David H.

AU - Reddy, Shailaja R.

AU - Look, Katherine Y.

AU - Yiannoutsos, Constantin

AU - Randall, Marcus E.

AU - Cardenes, Higinia R.

PY - 2005/3

Y1 - 2005/3

N2 - Objective. A phase II study was conducted to evaluate the role of adjuvant intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy in patients with uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CCC), after complete surgical staging. Methods. Patients were required to have undergone complete surgical staging including maximal surgical resection. Residual ≤3 mm intraperitoneal disease, and pelvic and para-aortic lymph node dissection with negative nodes, were required. A dose of 15 mCi of intraperitoneal 32P was administered within 8 weeks of surgery. Vaginal brachytherapy was delivered using either high dose rate, total dose of 2100 cGy in 3 fractions (700 cGy per fraction prescribed to 0.5 cm depth from the vaginal surface) or low dose rate to 6500 cGy (prescribed to the vaginal surface) in 1-2 fractions. Results. For the 21 evaluable patients, distribution by FIGO stage was as follows: Stages I-IIB (17), Stages III-IV (4). The median follow-up was 39.6 months (range: 5-63 months). No patients experienced grade 2-4 complications from their adjuvant therapy. Five patients suffered a recurrence: intraperitoneal [n = 2], distal vaginal [n = 2], and one at the surgical scar. Following the 2 distal vagina recurrences early in the trial, the entire length of the vagina was treated with intracavitary brachytherapy. No additional vaginal recurrences were observed. The two-year overall survival, cause-specific survival, and disease-free survival for the entire series were 89.2%, 89.2%, and 79.7%, respectively. Conclusions. Adjuvant therapy for UPSC and CCC with intraperitoneal 32P and vaginal brachytherapy after comprehensive surgical staging is feasible, well tolerated, and warrants further study on a larger scale.

AB - Objective. A phase II study was conducted to evaluate the role of adjuvant intraperitoneal radioactive phosphorus (32P) and vaginal brachytherapy in patients with uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CCC), after complete surgical staging. Methods. Patients were required to have undergone complete surgical staging including maximal surgical resection. Residual ≤3 mm intraperitoneal disease, and pelvic and para-aortic lymph node dissection with negative nodes, were required. A dose of 15 mCi of intraperitoneal 32P was administered within 8 weeks of surgery. Vaginal brachytherapy was delivered using either high dose rate, total dose of 2100 cGy in 3 fractions (700 cGy per fraction prescribed to 0.5 cm depth from the vaginal surface) or low dose rate to 6500 cGy (prescribed to the vaginal surface) in 1-2 fractions. Results. For the 21 evaluable patients, distribution by FIGO stage was as follows: Stages I-IIB (17), Stages III-IV (4). The median follow-up was 39.6 months (range: 5-63 months). No patients experienced grade 2-4 complications from their adjuvant therapy. Five patients suffered a recurrence: intraperitoneal [n = 2], distal vaginal [n = 2], and one at the surgical scar. Following the 2 distal vagina recurrences early in the trial, the entire length of the vagina was treated with intracavitary brachytherapy. No additional vaginal recurrences were observed. The two-year overall survival, cause-specific survival, and disease-free survival for the entire series were 89.2%, 89.2%, and 79.7%, respectively. Conclusions. Adjuvant therapy for UPSC and CCC with intraperitoneal 32P and vaginal brachytherapy after comprehensive surgical staging is feasible, well tolerated, and warrants further study on a larger scale.

UR - http://www.scopus.com/inward/record.url?scp=13844280283&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13844280283&partnerID=8YFLogxK

U2 - 10.1016/j.ygyno.2004.11.050

DO - 10.1016/j.ygyno.2004.11.050

M3 - Article

VL - 96

SP - 818

EP - 823

JO - Gynecologic Oncology

JF - Gynecologic Oncology

SN - 0090-8258

IS - 3

ER -