Carcinoma of the uterine cervix: Twice-versus once-weekly high-dose-rate brachytherapy

Citation
Y. Hama et al., Carcinoma of the uterine cervix: Twice-versus once-weekly high-dose-rate brachytherapy, RADIOLOGY, 219(1), 2001, pp. 207-212
Citations number
23
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Journal title
RADIOLOGY
ISSN journal
0033-8419 → ACNP
Volume
219
Issue
1
Year of publication
2001
Pages
207 - 212
Database
ISI
SICI code
0033-8419(200104)219:1<207:COTUCT>2.0.ZU;2-3
Abstract
PURPOSE: To compare the effectiveness and safety of once; versus twice-week ly high-dose-rate (HDR) brachytherapy for cervical cancer. MATERIALS AND METHODS: From 1980 to 1997, 124 consecutive previously untrea ted patients with cervical cancer were treated with externa-beam irradiatio n (50 Gy) and HDR brachytherapy. Clinical stages were 1, 4 (3%) patients II , 51 (41%); III, 64(52%); and IV,5(4%). From 1980 to 1992, 74 patients (gro up A) were treated with HDR brachytherapy once weekly (about three fraction s of 7 Gy each to point A [2 cm superior and 2 cm lateral to the inferior e nd of the intrauterine radioactive source]), while from 1992 to 1997, 50 pa tients (group B) were treated twice weekly (about six fractions of 4.5 Cy-e ach to point-A). RESULTS: Overall survival rate at 5 years was 65.2% in group A and 65.3% in group B (P=.96). Local recurrence-free survival rate at 5 years was 69% (5 1 of 74 patients) in group A and 90% (45 of 50 patients) in group B (P<.001 ).The rate of grade 2 (moderate) and grade 3 (severe) complications was sig nificantly lower in group B (6% vs 32% in group A, P <.001). At multivariat e analysis, the variables significantly associated with increased local-reg ional recurrence rates were having stage III-IV lesions (P =.04) and with f ewer than six sessions of HDR brachytherapy P=.02). CONCLUSlON: The twice-weekly HDR regimen may improve the local control rate with fewer complications.