J Korean Med Sci.  2004 Feb;19(1):87-94. 10.3346/jkms.2004.19.1.87.

A Prospective Randomized Study on Two Dose Fractionation Regimens of High-Dose-Rate Brachytherapy for Carcinoma of the Uterine Cervix: Comparison of Efficacies and Toxicities Between Two Regimens

• Nam TK
• Ahn SJ

• KMID: 1785700
• DOI: http://doi.org/10.3346/jkms.2004.19.1.87

Abstract

To evaluate the toxicities and efficacies of two fractionation regimens of high-doserate brachytherapy in uterine cervical cancer, patients were stratified by stage Ib- IIa versus IIb-IVa, and randomly assigned to receive 3 Gy fractions (group A) or 5 Gy fractions (group B). External radiotherapy was performed using a 10 MV radiography with a daily 1.8 Gy up to 30.6 Gy to the whole pelvis, and then with a midline shield up to 45.0 Gy. Brachytherapy was performed with 3 Gy x 10 times or 5 Gy x5 times, and this was followed by booster brachytherapy of a smaller fraction to the residual tumor. Between August 1999 to July 2000, 46 patients were eligible. Median follow-up period was 42 months (5-49). The range of age was 37-83 yr (median, 58). The three-year disease-specific survival rates of group A (n=23) and B (n=23) were 90.5%, 84.9%, respectively (p=0.64). The three-year pelvic control rates of group A and B were 90.0% and 90.9%, respectively (p=0.92). The incidences of late complications of the rectum or bladder of grade 2 or greater in groups A and B were 23.8% and 9.1%, respectively (p=0.24). Our study showed that the results of two regimens were comparable. Fractionation regimen using 5 Gy fractions seems to be safe and effective, and offers shorter treatment duration.

Keyword

Cervix Neoplasms; Brachytherapy; Dose Fractionation; Prospective Studies

MeSH Terms

Adult
Aged
Aged, 80 and over
Brachytherapy/*methods
Carcinoma/mortality/*radiotherapy
Cervix Neoplasms/mortality/*radiotherapy
Combined Modality Therapy
Disease-Free Survival
*Dose Fractionation
Female
Human
Middle Aged
Prospective Studies
Time Factors
Treatment Outcome

Figure

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  Fig. 1 3-yr overall survival (OS) and 3-yr disease-specific survival (DSS) in all patients (n=46).

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  Fig. 2 3-yr overall survival according to the FIGO Ib-IIa (n=21) and IIb-III (n=25).

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  Fig. 3 3-yr overall survival according to the group A (n=23) and group B (n=23).

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  Fig. 4 3-yr disease-specific survival according to the group A (n=23) and group B (n=23).

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  Fig. 5 3-yr cumulative pelvic control rate according to the group A (n=21) and group B (n=22).

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