Author/Editor     Roman, TN; Souhami, L; Freeman, CR; Pla, C; Evans, MD; Podgoršak, EB; Mendelew, K
Title     High dose rate afterloading intracavitary therapy in carcinoma of the cervix
Type     članek
Source     Int J Radiat Oncol Biol Phys
Vol. and No.     Letnik 20, št. 5
Publication year     1991
Volume     str. 921-6
Language     eng
Abstract     From January 1984 through December 1986, 87 patients with previously untreated carcinoma of the cervix received external beam pelvic irradiation and high dose rate intracavitary therapy (HDRT). There were 18 Stage IIA patients, 39 Stage IIB, and 30 Stage IIIB. The median age was 60 years and the median follow-up time was 42 months for patients at risk. Radiotherapy consisted of external megavoltage irradiation to the whole pelvis (median dose 4600 cGy) combined with one (6 patients), two (51 patients), or three (30 patients) HDRT insertions. A high dose rate remote afterloading unit with 60Co sources was used to deliver the HDRT. The prescribed dose to point A was between 800 and 1000 cGy per treatment. The dose rate at point A initially was approximately 150 cGy/min and dropped to approximately 100 cGy/min during the duration of the study. Treatments with multiple fractions were given at weekly intervals. The overall actuarial survival at 5 years was 88 percent for Stage IIA, 64 percent for Stage IIB and 32 percent for Stage IIIB patients. Pelvic recurrence remained the major cause of failure. Grade III and IV late complications included proctitis and bowel obstruction in six patients each. We conclude that HDRT results are similar to those obtained with conventional low dose rate intracavitary systems. HDRT is cost effective and minimizes exposure to personnel. Several questions, such as the total number of insertions required, dose per HDRT insertion, and optimal HDRT insertion schedule remain unanswered and further experience is needed to better clarify these issues.
Descriptors     BRACHYTHERAPY
CERVIX NEOPLASMS
ADULT
AGED
AGED, 80 AND OVER
BRACHYTHERAPY
CERVIX NEOPLASMS
MIDDLE AGE
RADIOTHERAPY, HIGH-ENERGY
RETROSPECTIVE STUDIES
SURVIVAL RATE