A phase II evaluation of aerosolized GM-CSF (AGM-CSF) plus standard I-MAP/ GM-CSF/MAP/ surgery/ irradiation in the reduction of pulmonary metastases (P-METS) in soft tissue sarcoma (STS) patients (PTS)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10058-10058
Author(s):  
S. H. Okuno ◽  
M. R. Mahoney ◽  
B. F. Kabat ◽  
R. M. Marks ◽  
W. J. Maples ◽  
...  
Keyword(s):  
Pulmonary Metastases ◽  
Treatment Sequence ◽  
Debulking Surgery ◽  
Gm Csf ◽  
Median Size ◽  
Proximal Extremity ◽  
Ecog Ps ◽  
Disease Free ◽  
Free Rate

10058 Background: P-METs remain illusive with standard treatments for STS. AGM-CSF demonstrated tolerability with promising efficacy in reducing P-METS. We evaluated the 2-yr P-MET free rate in chemonaiive pts with extremity STS. Methods: ECOG PS 0/1 and Gr 3/4 primary STS of the limb girdle/extremities, were required. Treatment sequence: 2 cycles of IMAP (Ifosfamide, Mitomycin, Doxorubicin, Cisplatin) plus s.q. GM-CSF (preload d -6 to -3, d1–14); MAP (d0, 28) during irradiation (d1–35) plus AGM-CSF 250 mcg bid (d1–7, 15- 22, 28–35); surgery; post-op irradiation plus AGM-CSF 250 mcg bid (d1–7, 15–22, 28–35, 42–49). 6 of 35 pts with P-METS in ≤ 2 yrs implied lack of efficacy w.r.t. reducing P-METS. Results: 38 eligible pts were enrolled (20 male, median age 51 yrs, 24 PS 0). Median size of tumor 9 cm (2.3–26.7 cm).Location of tumors included: proximal extremity-16, distal extremity-11, and limb girdle-12. 79% received debulking surgery; 29 rendered disease-free. 38 pts are evaluable for toxicity (see table ). More common Gr 3+ events related to treatment appear below. 79% had Gr 4 neutropenia, despite s.q. GM-CSF. 6 pts have died, with 2.5 yrs median follow-up on survivors (range .4- 4.6). No treatment related fatalities occurred. 10 pts had P-METS ≤ 2 yrs. The estimated 2 yr P-MET free rate is 75% (95% CI 62–91). Conclusions: Although high, neutropenia was as expected. AGM-CSF failed to improve the 2 yr P-MET free rate in this group of STS pts. Other strategies need to be explored. Supported by NIH Grant CA15083–32 and Berlex Corporation. Max Severity (Gr 3+) [Table: see text] No significant financial relationships to disclose.

Radiotherapy as initial treatment for bulky stage II testicular seminomas.

1985 ◽  
Vol 3 (10) ◽  
pp. 1333-1338 ◽  
Author(s):  
S R Smalley ◽  
R G Evans ◽  
R L Richardson ◽  
G M Farrow ◽  
J D Earle
Keyword(s):  
Initial Treatment ◽  
Stage Ii ◽  
Uicc Stage ◽  
Median Dose ◽  
Bulky Disease ◽  
Median Size ◽  
Initial Recurrence ◽  
Primary Radiotherapy ◽  
Disease Free

Sixteen consecutive patients with bulky stage II seminoma were treated with primary radiotherapy from 1971 to 1982. Bulky stage II seminoma was defined as either Union Internationale Contre le Cancer (UICC) stage IIC (retroperitoneal metastases greater than 5 cm) or IID (palpable retroperitoneal metastases) with no evidence of visceral or supradiaphragmatic disease. The median age was 38 years (range, 26 to 52) and the median size of retroperitoneal disease was 11.5 cm (range, 5 to 25 cm). Patients were treated with generous radiation ports (such as wide hockey-stick or whole abdomen) often followed by boosts to the sites of bulky disease. Median tumor dose was 3,235 cGy (range, 2,700 to 5,668 cGy). Mediastinal (with or without supraclavicular) prophylactic radiation was administered to 15 of the 16 patients with a median dose of 2,590 cGy (range, 1,200 to 3,700 cGy). Treatment toxicity was mild. All 16 patients achieved a complete remission (CR) with radiotherapy. Median follow-up from the time of diagnosis was 60 months, and all patients are currently disease-free. Two patients recurred after therapy but were rendered disease-free with further radiation. These two relapsing patients have remained disease-free, following initial recurrence, for 8 years. The excellent results obtained with modern imaging and radiotherapeutic techniques justify radiotherapy as the initial treatment of choice for bulky stage II seminomas.

Idiotype vaccine therapy of follicular lymphoma in first remission: Association of t(14;18) and disease free survival in a phase II cohort

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7582-7582
Author(s):  
B. L. Gause ◽  
S. S. Neelapu ◽  
C. M. Cohen ◽  
L. M. Katz ◽  
T. Watson ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Chromosomal Translocation ◽  
Disease Free Survival ◽  
Keyhole Limpet Hemocyanin ◽  
Rank Test ◽  
Chi Square ◽  
Free Survival ◽  
Gm Csf ◽  
Disease Free

7582 Background: A single-arm Phase 2 study (Nature Med 5:1171–7,1999), evaluated the ability of tumor-specific idiotype (Id) conjugated to keyhole limpet hemocyanin (KLH) administered with granulocyte-monocyte colony-stimulating factor - GM-CSF (BiovaxID vaccine) to induce complete remission (CR) and molecular remission (MR) in follicular NHL patients in first CR after chemotherapy. We reported (ASH 2005, Abstr 2441) that at 9.2 years follow-up, disease free survival (DFS) and overall survival (OS) were 45% and 95%, respectively; median DFS was 8.0 years. Previous studies indicated that the t(14;18) chromosomal translocation is associated with follicular NHL. We tested the hypothesis that absence of t(14;18) in peripheral blood (PB) of patients after Id vaccination is predictive of DFS. Methods: A 20-patient cohort in first CR treated with the vaccine was evaluated. t(14;18)- (MR) is defined as <1 t(14;18)+ cell in 105 cells using PCR of the MBR breakpoint cluster on DNA from tumor biopsies or PB. Of the 20 patients, 11 had t(14;18)+ tumors and PB before chemotherapy. Following chemotherapy all 11 patients continued to have t(14;18)+ PB despite being in CR. However, at 1 month following final vaccine treatment, 8 of these patients had converted to t(14;18)- . In this ad hoc analysis, the proportion of patients remaining in DFS was stratified by t(14;18) status; Kaplan-Meier analysis compared median DFS of patients across t(14;18) status following vaccination. Results: At median follow-up of 9.2 years, 55% of patients had clinically relapsed. Although not statistically significant, of the 17 patients t(14;18)- post-vaccine, only 47.1% had clinically relapsed while 100% of the 3 t(14;18)+ patients had relapsed [Chi-square test; P=0.089]. Median DFS in t(14;18)+ patients was 60 months (5.0 years) and had not yet been reached in t(14;18)- patients at 91 months (7.6 years) [Log-rank test; P=0.069]. Conclusions: These data show a possible association between t(14;18) negativity following vaccine and prolonged DFS. Additional follow-up on these patients is needed, as well as similar analyses in other cohorts, to further explore this association. [Table: see text]

Final analysis of nelipepimut-S plus GM-CSF with trastuzumab versus trastuzumab alone to prevent recurrences in high-risk, HER2 low-expressing breast cancer: A prospective, randomized, blinded, multicenter phase IIb trial.

2019 ◽  
Vol 37 (8_suppl) ◽  
pp. 1-1 ◽  
Author(s):  
Annelies Hickerson ◽  
G. Travis Clifton ◽  
Diane F. Hale ◽  
Kaitlin M. Peace ◽  
Jarrod P. Holmes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Interim Analysis ◽  
Prolonged Exposure ◽  
Early Stage ◽  
Final Analysis ◽  
Control Group ◽  
Gm Csf ◽  
Disease Free ◽  
Clinical Trial Information

1 Background: Preclinical data shows synergism between trastuzumab (Tz) and HER2-targeted vaccines. We evaluated adjvuant nelipepimut-S (NPS) + GM-CSF with Tz compared to Tz with GM-CSF alone in HER2 low-expressing (LE) breast cancer (BC) patients (pts) to prevent recurrences. After a planned interim analysis showed benefit in triple negative BC (TNBC) pts, the decision was made to close the trial with guidance from the independent DSMB. Here, we report the final analysis of the trial with 7 months (mo) of added follow-up (f/u). Methods: The phase 2b trial enrolled clinically disease-free BC pts after standard therapy. Pts were HLA-A2, A3, A24, and/or A26+, had HER2-LE (IHC 1-2+, FISH non-amplified) BC and were node positive and/or TNBC. Pts were randomized to placebo with GM-CSF(control group, CG) or NPS with GM-CSF (vaccine group, VG), while all received Tz Q3wk for 1 year. GM-CSF or NPS + GM-CSF were given q3wks x 6 starting with the 3rd Tz dose, and boosters every 6 months x 4. Safety was assessed and pts were followed clinically for recurrences. The primary outcome was DFS at 24 mo. Results: 589 pts were screened at 26 sites. 275 pts were enrolled and randomized (VG:136, CG:139). There were no clinicopathologic differences between groups. Concurrent Tz and NPS was safe with no added overall or cardiac toxicity compared to CG and no grade 4/5 toxicities. In the ITT analysis (median f/u 25.7 mo), the estimated DFS was favorable but did not reach significance in the VG compared with the CG (HR 0.62, 95% CI: 0.31-1.25, p = 0.18). In the TNBC pts, the VG had statistically improved DFS compared to the CG (HR 0.26, 95% CI: 0.08-0.81, p = 0.013). Conclusions: The combination of NPS with Tz is safe with no added toxicity compared to Tz alone, even after prolonged exposure (25.7 mo). In this final analysis, there was a trend towards benefit in the ITT population that improved since the interim analysis with added f/u. The significant benefit seen at interim in the TNBC pts continued to strengthen in the VG group. These findings could position the NPS + Tz combination as an adjuvant therapy for early-stage TNBC and warrant further study. Clinical trial information: NCT01570036.

Prognostic factors in pediatric differentiated thyroid cancer patients with pulmonary metastases

2015 ◽  
Vol 28 (7-8) ◽  
Author(s):  
Chandra Sekhar Bal ◽  
Aayushi Garg ◽  
Saurav Chopra ◽  
Sanjana Ballal ◽  
Ramya Soundararajan
Keyword(s):  
Thyroid Cancer ◽  
Prognostic Factors ◽  
Differentiated Thyroid Cancer ◽  
Pulmonary Metastases ◽  
Disease Course ◽  
Factors Associated ◽  
Disease Characteristics ◽  
Surgical Methods ◽  
Disease Free

AbstractThis study was aimed at identifying the prognostic factors predicting remission in pediatric differentiated thyroid cancer (DTC) patients presenting with pulmonary metastases. Little is known about the prognostic factors in reference to pediatric DTC patients presenting with pulmonary metastases.Fifty-three DTC patients aged ≤21 years were diagnosed with pulmonary metastases at initial presentation. The demographic and disease characteristics were compared between the patients who achieved remission and those who did not.During the median follow-up of 72 months, 38 patients became disease free, 14 patients had biochemically and/or structurally persistent disease, and one patient died due to disease progression. Patient age >15 years, presence of macronodular pulmonary metastases, and surgical methods lesser than total/near-total thyroidectomy were identified as factors associated with reduced odds of remission.This study describes the disease course and depicts the disease related prognostic factors in pediatric DTC patients with pulmonary metastases.

Lyposomal Doxorubicin (Caelyx), Cyclophosphamide - Rituximab (DC-R) Plus GM-CSF as a Salvage Therapy in B-Diffuse Large Cell Lymphoma (B-DLCL) after Autologous Stem Cell Transplantation (ASCT) Failure.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1502-1502
Author(s):  
Attilio Olivieri ◽  
Mauro Montanari ◽  
Debora Capelli ◽  
Ilaria Scortechini ◽  
Guido Gini ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Disease Free Survival ◽  
Disease Status ◽  
Large Cell ◽  
Salvage Chemotherapy ◽  
Cardiac Damage ◽  
Free Survival ◽  
Gm Csf ◽  
Disease Free

Abstract B-DLCL patients after ASCT failure have a very poor prognosis, salvage chemotherapy or a second transplantation cannot substantially modify the very poor outcome which is characterized by a median overall survival (OS) of 3 months. We recently demonstrated the feasibility of chemoimmunotherapy after ASCT by associating a CHOP-modified schedule+Rituximab and GM-CSF, but often the antracycline retreatment in these patients can be hampered by the risk of severe cardiac damage or by a reduced organ reserve. For this reason we adopted a modified version of this protocol for patients receiving a previous Doxorubicin cumulative dose&gt;300 mg/sm, with the substitution of conventional antracycline with a Lyposomal Pegylated Doxorubicin (DC-R schema); the other inclusion criteria were: diagnosis of B-DLCL CD20+, P.S (WHO)= 0–2, age &lt; 75 years, relapse or progressive disease (PD) after ASCT, measurable disease, absence of severe organ dysfunction and CNS involvement. Seventeen patients were eligible for this salvage protocol; the median age was 47 (28–73) years; the P.S. (WHO) was 0–1 in 11 patients and 2 in six; the disease status after ASCT was: untested relapse in 14 cases and PD in 3 cases. The DC-R + GM-CSF schema (every three weeks) consisting in: R 375 mg/sm day 1 and 15, Caelyx 30 mg/sm and cyclophosphamide 750 mg/sm day 1, GM-CSF 150 mg/day from day 5 until neutrophils recovery. Patients showing disease progression after two courses were excluded while the responders received two more coursesof DC-R+GM-CSF; patients achieving complete remission (CR) after 4 courses did not receive any further treatment. All the17 patients received the planned treatment and were evaluable for response: the overall response rate (ORR) was 58.8% with 10 CR (58.8%), 7 patients showed a PD after 1–2 courses. The toxicity (WHO) consisted in: grade III–IV neutropenia in 11 patients (64.7%) and thrombocytopenia in 2 patients (23.5%), grade I–II infections in 2 patients and grade IV (pneumonia) in one patient. With a median follow up of 15 (1–74) months, 8 out of 10 responders patients are alive and in CR with a median disease-free survival of 24.5 (8–70) months, one patient is alive and in relapse at + 23 months and 1 patients died for infection months after while in CR. Our experience shows that DC-R + GM-CSF is an effective salvage treatment for B-DLCL after ASCT failure; indeed the follow up &gt; 12 months in 5/17 (29.4%) patients in CR suggests a chance of cure.

Improved prognosis of diffuse histiocytic and undifferentiated lymphoma by use of high dose methotrexate alternating with standard agents (M-BACOD).

1983 ◽  
Vol 1 (2) ◽  
pp. 91-98 ◽  
Author(s):  
A T Skarin ◽  
G P Canellos ◽  
D S Rosenthal ◽  
D C Case ◽  
J M MacIntyre ◽  
...  
Keyword(s):  
Remission Rate ◽  
New Combination ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Prior Therapy ◽  
Dose Methotrexate ◽  
The Central Nervous System ◽  
Disease Free ◽  
Free Rate

A new combination chemotherapy program (M-BACOD) was administered to 101 patients with advanced diffuse histiocytic and diffuse undifferentiated lymphoma (DHL and DUL). High dose methotrexate (M) 3 g/m2 with leucovorin factor rescue was given on day 14 between cycles of bleomycin (B), adriamycin (A), cyclophosphamide (C), oncovin (O), and dexamethasone (D) administered every 3 weeks for 10 cycles. The complete remission rate (CR) was 72% in all 101 patients or 77% in 95 evaluable patients. The median follow-up is 3 yr 2 mo with one-third of CR patients followed beyond 4 yr. Twenty-six percent of CR patients have relapsed with a projected 5-yr survival rate of 80% (5-yr disease-free rate 65%). The overall survival of all 101 study patients reaches a plateau at 59% projected out to 5 yr. Patients with prior therapy had a significantly lower CR rate than those without prior treatment (p = 0.001); however, no other unfavorable prognostic characteristics could be identified. Relapse in the central nervous system CNS occurred in only 5.4% of CR patients. M-BACOD results in prolonged survival and possible cure in a high proportion of all patients with DHL and DUL.

A safety and efficacy trial of lethally irradiated allogeneic pancreatic tumor cells transfected with the GM-CSF gene in combination with adjuvant chemoradiotherapy for the treatment of adenocarcinoma of the pancreas

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 3010-3010 ◽  
Author(s):  
D. Laheru ◽  
C. Yeo ◽  
B. Biedrzycki ◽  
S. Solt ◽  
E. Lutz ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Surgical Resection ◽  
Cell Lines ◽  
Pancreatic Tumor ◽  
Pancreas Cancer ◽  
Adjuvant Chemoradiotherapy ◽  
Published Data ◽  
Gm Csf ◽  
Disease Free

3010 Background: Pancreatic cancer remains the fourth leading cause of cancer related deaths in the US in 2006. Surgical resection provides the only possibility of cure. A standard adjuvant treatment approach for patients with resected disease has not yet been determined. We have developed an irradiated GM-CSF transfected allogeneic whole cell line pancreas adenocarcinoma vaccine. We have previously reported a follow-up 60 patient study in this same population using the highest bioactive vaccine dose identified in the initial phase I study. Methods: Single institution phase II study of 60 patients with resected pancreatic adenocarcinoma administered a total of 5 vaccines using two pancreatic cancer cell lines each delivering 2.5 X 10 8 cells ID. Vaccine one was administered 8–10 weeks following surgical resection. Patients subsequently were treated with 5-FU CI based chemotherapy integrated with radiotherapy. Patients who were disease-free one month after completion of chemoradiotherapy received vaccines 2–4, each 1 month apart. A fifth and final booster vaccine was administered 6 months after vaccine 4. The objectives of the study were: 1. To estimate overall survival and disease-free survival in patients with minimal residual disease treated with adjuvant chemoradiotherapy in sequence with the irradiated allogeneic GM-CSF transfected pancreatic tumor cell lines. 2. To characterize toxicities associated with intradermal injections of the vaccine. Results/Conclusions: The study completed enrollment of new patients in January 2005. Median follow-up for these patients is approximately 36 months. 1) The administration of a GM-CSF allogeneic pancreas cancer vaccine is safe and well tolerated; 2) The median survival is approximately 26 months. These results compare favorably with published data for resected pancreas cancer; 3) A matched cohort analysis comparing patients enrolled on this adjuvant vaccine study to the Johns Hopkins Surgery database of patients receiving surgery followed by chemoradiotherapy alone will be presented at this meeting; 4) Immune correlates will be presented at this meeting. No significant financial relationships to disclose.

Adjuvant systemic chemotherapy with or without bevacizumab in patients with resected pulmonary metastases from colorectal cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e14533-e14533
Author(s):  
Nedim Turan ◽  
Faysal Dane ◽  
Olcun Umit Unal ◽  
Mustafa Benekli ◽  
Hasan volkan Kara ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Pulmonary Metastases ◽  
Univariate Analysis ◽  
Pulmonary Metastasectomy ◽  
Disease Free Interval ◽  
Free Survival ◽  
Lymphatic Involvement ◽  
Significant Difference ◽  
Disease Free

e14533 Background: To determine impact of modern chemotherapy regimens after pulmonary metastasectomy from colorectal cancer (CRC). Methods: A total of 122 consecutive patients who curatively resected for pulmonary metastases of CRC in eleven oncology centers were retrospectively analysed between January 2000 and April 2012. Results: Of 122 patients, 108 who received chemotherapy with fluoropyrimidine-based (n = 12), irinotecan-based (n = 56) and oxaliplatin-based (n = 40) combinations were analyzed. Among these, 52 patients received bevacizumab (BEV) while 56 did not (NoBEV). With a median follow-up of 14 months after metastasectomy, median recurrence-free survival (RFS) was 17 months, overall survival (OS) was not reached. Three and 5-years OS rates were 66% and 53%, respectively. There was no significant difference among cytotoxic regimens in respect to RFS and OS. Similarly, no significant difference was seen between BEV and NoBEV arms in respect to OS and RFS. In univariate analysis prior liver metastasectomy (p = 0.045), positive pulmonary margin (p = 0.028), disease-free interval < 12 months (p = 0.013), and KRAS mutation (0.009) were negative significant prognostic for RFS. Thoracic pathological lymphatic involvement (p = 0.006) and higher prethoracotomy carcinoembryonic antigen (p = 0.038) were negative significant prognostic for OS. In multivariate analysis, positive pulmonary margin was the only negative independent prognostic for RFS, while thoracic lymphatic involvement was the only negative independent prognostic for OS. Conclusions: Chemotherapy type and addition of bevacizumab have no impact on both RFS and OS in the adjuvant setting following complete resection of colorectal pulmonary metastases.

Retrospective analysis of patients with sentinel lymph node (SLN) positive melanoma (MEL) who received adjuvant nivolumab (NIVO) without completion lymph node dissection (CLND).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 9590-9590
Author(s):  
Zeynep Eroglu ◽  
Nalan Babacan ◽  
Kenneth F. Grossmann ◽  
Joseph Markowitz ◽  
Andrew Scott Brohl ◽  
...  
Keyword(s):  
Lymph Node ◽  
Retrospective Analysis ◽  
Nodal Basin ◽  
Grade 3 ◽  
One Year ◽  
In Transit ◽  
Braf Mutant ◽  
Disease Free ◽  
Free Rate

9590 Background: Until recently, most patients (pts) with SLN+ MEL underwent CLND, a procedure mandated in published trials of adjuvant anti-PD-1 therapy to date. Following MSLT-II, this practice has dramatically changed with most pts now undergoing surveillance or adjuvant therapy without CLND. In addition, pts with in-transit/satellite MEL were excluded or not reported in these prior adjuvant studies. Our aim was to explore real-world outcomes of adjuvant NIVO in these pts. Methods: We carried out a single center retrospective analysis of stage 3 MEL pts who received adjuvant NIVO. Results: 32 pts with SLN+ MEL who did not undergo a CLND and started adjuvant NIVO within 3 months of surgery were included. Median age was 60 (26-77); per AJCC v7, 12 pts had Stage 3A, 11 stage 3B, and 9 pts had Stage 3C MEL. One was acral MEL; 18 had an ulcerated primary. 6 pts had BRAF-mutant MEL, 20 had BRAF-WT, and 6 unknown. NIVO treatment was 240 mg Q2wks or 480 mg Q4wks, up to one year. 21 pts developed grade 1/2 immune-related adverse events (irAEs), and 1 pt stopped NIVO due to toxicity (fatigue). With median follow-up of 7 months, only 1 pt had a recurrence, which was in the in SLN+ nodal basin; pt was rendered disease-free with surgery. The relapse-free rate (RFS) rate at 1 year was 95% (95% CI, 71-100). Of 21 pts with in-transit/satellite recurrent MEL (median age 68 [29-84]) who started adjuvant NIVO (no prior drug treatment), 5 had BRAF-mutant MEL, 14 BRAF-WT, 2 unknown; two were acral-lentiginous. 3 pts had recurrences: 2 regional and 1 distant mets, treated with surgery, TVEC, or BRAF-targeted therapy. Median follow-up was 8 months from NIVO start; 1-year RFS was 72% (95% CI 32-91). 15 pts developed irAEs; in 12, these were grade 1-2 and in 3, were grade 3 that led to discontinuation. Conclusions: While preliminary, these findings suggest that adjuvant anti-PD-1 therapy may be effective in SLN+ pts who forego CLND prior to adjuvant treatment, as 1-year RFS rate appears similar to rates in the published adjuvant anti-PD-1 trials that mandated CLND. This therapy may be similarly effective in pts with resected in-transit/satellite stage 3 melanoma. Further follow-up will be presented.

scholarly journals Single-Fraction Adjuvant Electronic Brachytherapy after Resection of Conjunctival Carcinoma

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 454
Author(s):  
Gustavo R. Sarria ◽  
Solon Serpa ◽  
Mario Buitrago ◽  
Paola Fuentes Rivera ◽  
Diego Ramirez ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Biological Effect ◽  
Disease Free Survival ◽  
Free Survival ◽  
Single Fraction ◽  
Electronic Brachytherapy ◽  
Median Size ◽  
Prospective Assessment ◽  
Disease Free

A retrospective study was performed to assess the outcomes of a single-fraction adjuvant electronic brachytherapy (e-BT) approach for patients with squamous cell conjunctival carcinoma (SCCC). Forty-seven patients with T1–T3 SCCC were included. All patients underwent surgery followed by a single-fraction adjuvant e-BT with a porTable 50-kV device. Depending on margins, e-BT doses ranged between 18 to 22 Gy prescribed at 2 mm depth, resembling equivalent doses in 2 Gy (EQD2) per fraction of 46–66 Gy (α/β ratio of 8–10 Gy and a relative biological effect (RBE) of 1.3). The median age was 69 (29–87) years. Most tumors were T1 (40.4%) or T2 (57.5%) with a median size of 7 mm (1.5–20). Margins were positive in 40.4% of cases. The median time from surgery to e-BT was nine weeks (0–37). After a median follow-up of 24 (17–40) months, recurrence occurred in only two patients (6 and 7 months after e-BT), yielding a median disease-free survival (DFS) of 24 (6–40) months and DFS at two years of 95.7%. Acute grade 2 conjunctivitis occurred in 25.5%. E-BT is a safe and effective for SCCC treatment, with clinical and logistic advantages compared to classical methods. Longer follow-up and prospective assessment are warranted.

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