Kadın Genital Sistemin Nadir Bir Tümörü: Radyoterapi Uygulanmış Vajinal Tümörlü Olguların Tedavi Sonuçlarının Değerlendirilmesi
Küçük Resim Yok
Tarih
2019
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Vajen yerleşimli tümörler, kadın genital sistemin göreceli olarak oldukça nadir izlenen tümörlerini oluşturmaktadır. Amacımız, nadir izlenen vajen yerleşimli tümörlerimizin, özelliklerini ve tedavi yanıtlarını değerlendirmektir. Yöntem: Ocak 2000 ile Aralık 2017 yılları arasında kliniğimizde vajinal kitle nedeni ile eksternal radyoterapi (RT) uygulanmış 30 olgu retrospektif olarak değerlendirilmiştir. Tedavi 6-18 MV lineer akselatörler kullanılarak küratif tedavilerde 1.8 Gy/fx ile toplam ortanca 50.4 Gy(45-59.4 Gy), palyatif tedavilerde 3-5Gy/fx ile toplam ortanca 30 Gy(20-45Gy) uygulanmıştır. İstatistiksel analizler SPSS 23.0 kullanılarak yapılmıştır. Bulgular: Olgularımızın değerlendirilmesinde, ortanca yaş 69(aralık 33-84) olup; %50’si 70 ve üzeri yaştadır. FIGO evrelemesine göre; 11(%36,7)’i Evre 2, 11(%36,7)’i Evre 3, 4(%13,3)’ü Evre 4A ve yine 4(%13,3)’ü Evre 4B olarak evrelenmiştir. En sık izlenen patolojik tanı %63,3 (n=19) ile epidermoid karsinom olup, bunu %20 (n=6) ile adenokarsinom, %10 (n=3) ile sarkomlar ve %6,7 (n=2) ile malign melanom izlemektedir. Olguların 27 (%90)’sine küratif, 3 (%10)’üne ise palyatif amaçla RT uygulanmıştır. Ortanca 49,5(5-156 ) aylık izlem sürecinde; 8(%27)’inde lokal yineleme, 5(%17)’inde bölgesel yineleme ve 2(%7)’sinde ise her ikisi birden izlenmiştir. Başlangıçta uzak metastazı olmayan 4(%14) olguda izlem sürecinde uzak metastaz gelişmiştir. Beş-yıllık lokal-bölgesel, hastalıksız ve genel sağkalım oranları sırasıyla %48, %40 ve %52’dir.Çok değişkenli analizde olumsuz prognostik faktörler olarak;?70 yaş olmak(p=0.039), başlangıçta uzak yayılımlı olmak(p=0.023), tedaviye yanıt olmaması(p=0.018) ve epidermoid dışı histopatolojide hastalık(p=0.041) olarak bulunmuştur Sonuç: Multidisipliner yaklaşımlarla bile vajinal tümörler kötü prognoza sahiptir ve hastalar sıklıkla uzak yayılımlı evrede tanı almaktadır. Moleküler prognostik faktörlerin araştırılması bireyselleştirilmiş tedavilerin geliştirilmesi açısından gereklidir
Aim: Vaginal tumors are relatively rare tumors of female genital system. Our aim is to evaluate the features and treatment results of our are vaginal tumors. Material-Method: Thirty vaginal tumor patients treated between 2000 and 2017 at the Department of Radiation Oncology, Ege University Faculty of Medicine, were retrospectively reviewed. External radiotherapy (RT) was applied with 6-18 MV linear accelerators with1.8 Gy Daily fractions with a median total dose of 50.4 Gy (45-59.4 Gy) for curative cases and 3-5 Gy Daily fraction swith a median total dose of 30 Gy (20-45 Gy) for palliative cases. Statistical analyses were performed with SPSS v23.0. Results: Among 30 patients with a median age of 69 years (range 33- 84), 50% of them were 70 years and/or over. Twenty seven (90%) patients were treated with curative and 3 (10%) were treated with palliative purposes. According to International Federation of Gynecology and Obstetrics staging, 11 (36.7%) had stage II, 11 (36.7%) had stage III, 4 (13.3%) had stage IVA, and 4 (13.3%) had stage IVB disease. Within a median of 49.5 months (range 5-156) of follow-up, 8 (27%) patients had local recurrence,5 (17%) had regional recurrence, 2 (7%) had both local and regional recurrence, and 4 (14%) had distant metastases. Five-year locoregional, disease-free, and overall survival rates were 48%, 40%, and 52%, respectively. Being ?70 years(p=0.039), presenting with advanced disease(p=0.023), treatment resistant disease(p=0.018), and having non- epidermoid histology(p=0.041) were found to be unfavorable prognostic factors for disease-related outcomes in multivariate analyses. Conclusion: Prognosis of vaginal cancer remains pooreven with a multidisciplinary approach. Molecular prognostic factors need to be defined for individualized treatment options to achieve better treatment results
Aim: Vaginal tumors are relatively rare tumors of female genital system. Our aim is to evaluate the features and treatment results of our are vaginal tumors. Material-Method: Thirty vaginal tumor patients treated between 2000 and 2017 at the Department of Radiation Oncology, Ege University Faculty of Medicine, were retrospectively reviewed. External radiotherapy (RT) was applied with 6-18 MV linear accelerators with1.8 Gy Daily fractions with a median total dose of 50.4 Gy (45-59.4 Gy) for curative cases and 3-5 Gy Daily fraction swith a median total dose of 30 Gy (20-45 Gy) for palliative cases. Statistical analyses were performed with SPSS v23.0. Results: Among 30 patients with a median age of 69 years (range 33- 84), 50% of them were 70 years and/or over. Twenty seven (90%) patients were treated with curative and 3 (10%) were treated with palliative purposes. According to International Federation of Gynecology and Obstetrics staging, 11 (36.7%) had stage II, 11 (36.7%) had stage III, 4 (13.3%) had stage IVA, and 4 (13.3%) had stage IVB disease. Within a median of 49.5 months (range 5-156) of follow-up, 8 (27%) patients had local recurrence,5 (17%) had regional recurrence, 2 (7%) had both local and regional recurrence, and 4 (14%) had distant metastases. Five-year locoregional, disease-free, and overall survival rates were 48%, 40%, and 52%, respectively. Being ?70 years(p=0.039), presenting with advanced disease(p=0.023), treatment resistant disease(p=0.018), and having non- epidermoid histology(p=0.041) were found to be unfavorable prognostic factors for disease-related outcomes in multivariate analyses. Conclusion: Prognosis of vaginal cancer remains pooreven with a multidisciplinary approach. Molecular prognostic factors need to be defined for individualized treatment options to achieve better treatment results
Açıklama
Anahtar Kelimeler
0-Belirlenecek
Kaynak
Ege Klinikleri Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
57
Sayı
2
