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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 - J. Korean Med. Sci. (2004)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju 501-757, Korea.

ABSTRACT
To evaluate the toxicities and efficacies of two fractionation regimens of high-dose-rate 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 x 5 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.

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

Mentions: The 3-yr overall survival rate (3YOSR) of all 46 patients was 76.1% (Fig. 1). According to FIGO stage, the 3YOSRs of Ib-IIa (n=21) and IIb-III (n=25) were 90.5% and 64.0%, respectively (p=0.04, Fig. 2), and the 3YOSRs of groups A and B were 78.3% and 73.9%, respectively (p=0.85, Fig. 3). There was no significant difference in 3YOSRs by age (<60 yr vs. ≥60), histology, tumor diameter (≤4 cm vs. >4), radiological LAP (pelvic vs. paraaortic vs. none), radiotherapy duration (≤60 days vs. >60), total A point BED10 (≤110 Gy vs. >110), or chemotherapy (yes vs. no). A total of 11 patients died at the time of analysis, five patients from cervical cancer and the other six patients without evidence of cervical cancer. Thereby, the 3-yr disease-specific survival rate (3YDSSR) of all patients was 87.8%. The 3YDSSRs of groups A and B were 90.5% and 85.0%, respectively (p=0.71, Fig. 4). According to FIGO stage, the 3YDSSRs of Ib-IIa and IIb-III were 90.5% and 84.9%, respectively (p=0.64).


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 - J. Korean Med. Sci. (2004)

3-yr disease-specific survival according to the group A (n=23) and group B (n=23).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822271&req=5

Figure 4: 3-yr disease-specific survival according to the group A (n=23) and group B (n=23).
Mentions: The 3-yr overall survival rate (3YOSR) of all 46 patients was 76.1% (Fig. 1). According to FIGO stage, the 3YOSRs of Ib-IIa (n=21) and IIb-III (n=25) were 90.5% and 64.0%, respectively (p=0.04, Fig. 2), and the 3YOSRs of groups A and B were 78.3% and 73.9%, respectively (p=0.85, Fig. 3). There was no significant difference in 3YOSRs by age (<60 yr vs. ≥60), histology, tumor diameter (≤4 cm vs. >4), radiological LAP (pelvic vs. paraaortic vs. none), radiotherapy duration (≤60 days vs. >60), total A point BED10 (≤110 Gy vs. >110), or chemotherapy (yes vs. no). A total of 11 patients died at the time of analysis, five patients from cervical cancer and the other six patients without evidence of cervical cancer. Thereby, the 3-yr disease-specific survival rate (3YDSSR) of all patients was 87.8%. The 3YDSSRs of groups A and B were 90.5% and 85.0%, respectively (p=0.71, Fig. 4). According to FIGO stage, the 3YDSSRs of Ib-IIa and IIb-III were 90.5% and 84.9%, respectively (p=0.64).

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju 501-757, Korea.

ABSTRACT
To evaluate the toxicities and efficacies of two fractionation regimens of high-dose-rate 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 x 5 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.

Show MeSH
Related in: MedlinePlus