Compare The IMRT With3D-CRT For The Locally Advanced Cervical Cancer In Terms Of Toxicities And Clinical Outcomes

Purpose：To investigate whether IMRT is superior to3D-CRT for the locallyadvanced cervical cancer.Method：We reviewed86patients with Federation of Gynecology andObstetrics (FIGO2009) stage IIB-IVA cervical cancer, who werevolentary to participate in the IMRT group or3D-CRT group to receiveexternal beam radiotherapy(45-50.4Gy) followed by intracavitarybrachytherapy(per6Gy in5-6terms,totally30-36Gy) between October2011and March2013.Both groups received concurrentchemothrapy(docetaxel60mg/㎡and cisplatin40mg/㎡)，then extendedto the sixth cycle after radiotherapy.We compared the acutegastrointestinal complications, genitourinary complications andhemotological complications between two groups. The late rectum andbladder toxicities and remission response rates were also compared.OS(overall survival rate) and DFS(disease-free survival rate)wereestimated by use of Kaplan-meier method.Results：All patients completed the treatment,except8of them onlyreceived5cycles chemotherapy.The CR and PR rates in IMRT group and3D-CRT group were respectively88.9％vs85.4％and8.9％vs7.3％（P=0.524＞0.05）。Incidence of grade2or higher hematoglobin reduction was13.3%vs39.0％in IMRT group and3D-CRT grouprespectively（P=0.006＜0.05）, and the incidence of platelet reduction waslower in IMRT group(31.1%vs53.7％，P=0.034＜0.05).Patiens in IMRTgroup experienced less grade2or higher acute gastrointestinalcomplication than those in3D-CRT group (17.8％vs46.3％, P=0.004＜0.05). No significently difference in incidence of acute genitourinarycomplication was observed between two groups.The incidence of laterectum toxicity was15.6％vs48.8％in IMRT group and3D-CRT group（P=0.001＜0.05）respectively, and patiens in IMRT group had less grade2late rectum toxicity compared to patiens in3D-CRT group with2.2％vs17.1％（P=0.046＜0.05）. There was no significently difference inincidence of late genitourinary complications between two groups.Median follow-up time was19months(range,9-27months). OS was84.4％vs78.0％respectively in IMRT group and3D-CRT group(P=0.288＞0.05), and DFS was73.2%vs77.8%respectively in IMRT group and3D-CRT group(P=0.414＞0.05)Conclude：Compared with3D-CRT,IMRT is associated with lessgastrointestinal and hemotological toxicities,meanwhile with thecomparable efficacy and clinical outcomes.