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AbstractAbstract
[en] Purpose: To report the treatment results and rectal/bladder complications of cervical carcinoma radically treated with high-dose-rate intracavitary brachytherapy (HDR-IC). The current policy of using three-fraction scheme was examined. Methods and Materials: Between November 1987 and August 1990, 173 patients with cervical carcinoma were treated with curative-intent radiation therapy. Whole pelvic irradiation was administered with 10-MV X ray. Dose to the central cervix was 40-44 Gy in 20-22 fractions, following by pelvic wall boost 6-14 Gy in three to seven fractions with central shielding. 60Co sources were used for HDR-IC, and 7.2 Gy was given to Point A for three applications, 1-2 weeks apart. Duration of follow-up was 5-7.8 years. Results: Twenty-eight patients (16%) developed central-regional recurrences. Overall 5-year actuarial pelvic control rate was 83%. By stage, 5-year actuarial pelvic control rates were 94%, 87%, and 72% for Stages IB + IIA, IIB + IIIA, and IIIB + IVA, respectively. Thirty-one patients (18%) developed distant metastasis. Overall 5-year actuarial survival rate was 58%. By stage, 5-year actuarial survival rates were 79%, 59%, and 41% for Stages IB + IIA, IIB + IIIA, and IIIB + IVA, respectively. Sixty-six (38%) and 19 patients (11%) developed rectal and bladder complications, respectively. For rectal complication, the overall actuarial rate was 38% at 5 years. By grade, 5-year actuarial rectal complication rates were 24%, 15%, 4%, and 3% for Grades 1-4, respectively. Overall prevalence of rectal complications was 37% and 14% at 2 and 5 years, respectively. Prevalence of low-grade rectal complication (Grades 1 and 2) was dominant at 2 years (30%), but declined to 8% at 5 years. Prevalence of high-grade, severe rectal complication (Grades 3 and 4) remained steady at 2 and 5 years (7% and 6%, respectively). Five-year actuarial bladder complication was 9%. Five-year prevalence of bladder complication was 2%. Conclusion: Using a three-fraction scheme, survival rate appeared comparable with the existing results of the low-dose-rate technique. The incidence of rectal complication with this scheme remained relatively high. The increased part of rectal complication was predominately low grade. This result suggested that therapeutic gain with this scheme may not be good enough to circumvent its biologic disadvantage. Numbers of fractions >3 must be considered in future trials
Primary Subject
Source
S0360301696006244; Copyright (c) 1997 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Record Type
Journal Article
Journal
International Journal of Radiation Oncology, Biology and Physics; ISSN 0360-3016; ; CODEN IOBPD3; v. 38(2); p. 391-398
Country of publication
BETA DECAY RADIOISOTOPES, BETA-MINUS DECAY RADIOISOTOPES, BIOLOGICAL EFFECTS, BIOLOGICAL RADIATION EFFECTS, BODY, COBALT ISOTOPES, DIGESTIVE SYSTEM DISEASES, DISEASES, FEMALE GENITALS, IMPLANTS, INJURIES, INTERMEDIATE MASS NUCLEI, INTERNAL CONVERSION RADIOISOTOPES, IRRADIATION, ISOMERIC TRANSITION ISOTOPES, ISOTOPES, MINUTES LIVING RADIOISOTOPES, NEOPLASMS, NUCLEI, ODD-ODD NUCLEI, ORGANS, RADIATION EFFECTS, RADIATION SOURCES, RADIOISOTOPES, YEARS LIVING RADIOISOTOPES
Reference NumberReference Number
INIS VolumeINIS Volume
INIS IssueINIS Issue