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Methods, safety, and early clinical outcomes of dose escalation using simultaneous integrated and sequential boosts in patients with locally advanced gynecologic malignancies.

Publication ,  Journal Article
Boyle, J; Craciunescu, O; Steffey, B; Cai, J; Chino, J
Published in: Gynecol Oncol
November 2014

OBJECTIVE: To evaluate the safety of dose escalated radiotherapy using a simultaneous integrated boost technique in patients with locally advanced gynecological malignancies. METHODS: Thirty-nine women with locally advanced gynecological malignancies were treated with intensity modulated radiation therapy utilizing a simultaneous integrated boost (SIB) technique for gross disease in the para-aortic and/or pelvic nodal basins, sidewall extension, or residual primary disease. Women were treated to 45Gy in 1.8Gy fractions to elective nodal regions. Gross disease was simultaneously treated to 55Gy in 2.2Gy fractions (n=44 sites). An additional sequential boost of 10Gy in 2Gy fractions was delivered if deemed appropriate (n=29 sites). Acute and late toxicity, local control in the treated volumes (LC), overall survival (OS), and distant metastases (DM) were assessed. RESULTS: All were treated with a SIB to a dose of 55Gy. Twenty-four patients were subsequently treated with a sequential boost to a median dose of 65Gy. Median follow-up was 18months. Rates of acute>grade 2 gastrointestinal (GI), genitourinary (GU), and hematologic (heme) toxicities were 2.5%, 0%, and 30%, respectively. There were no grade 4 acute toxicities. At one year, grade 1-2 late GI toxicities were 24.5%. There were no grade 3 or 4 late GI toxicities. Rates of grade 1-2 late GU toxicities were 12.7%. There were no grade 3 or 4 late GU toxicities. CONCLUSION: Dose escalated radiotherapy using a SIB results in acceptable rates of acute toxicity.

Duke Scholars

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

November 2014

Volume

135

Issue

2

Start / End Page

239 / 243

Location

United States

Related Subject Headings

  • Vulvar Neoplasms
  • Uterine Cervical Neoplasms
  • Treatment Outcome
  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiation Dosage
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged
 

Citation

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Boyle, J., Craciunescu, O., Steffey, B., Cai, J., & Chino, J. (2014). Methods, safety, and early clinical outcomes of dose escalation using simultaneous integrated and sequential boosts in patients with locally advanced gynecologic malignancies. Gynecol Oncol, 135(2), 239–243. https://doi.org/10.1016/j.ygyno.2014.08.037
Boyle, John, Oana Craciunescu, Beverly Steffey, Jing Cai, and Junzo Chino. “Methods, safety, and early clinical outcomes of dose escalation using simultaneous integrated and sequential boosts in patients with locally advanced gynecologic malignancies.Gynecol Oncol 135, no. 2 (November 2014): 239–43. https://doi.org/10.1016/j.ygyno.2014.08.037.
Boyle, John, et al. “Methods, safety, and early clinical outcomes of dose escalation using simultaneous integrated and sequential boosts in patients with locally advanced gynecologic malignancies.Gynecol Oncol, vol. 135, no. 2, Nov. 2014, pp. 239–43. Pubmed, doi:10.1016/j.ygyno.2014.08.037.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

November 2014

Volume

135

Issue

2

Start / End Page

239 / 243

Location

United States

Related Subject Headings

  • Vulvar Neoplasms
  • Uterine Cervical Neoplasms
  • Treatment Outcome
  • Retrospective Studies
  • Radiotherapy, Intensity-Modulated
  • Radiation Dosage
  • Ovarian Neoplasms
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Middle Aged