Treatment Of Local Advanced Cervical Carcinoma With High-dose Rate Intracavitary Brachytherapy: Three Years Follow-up Study

Aims:This study focused on the efficacy and late complicationsof high-dose rate intracavitary brachytherapy (HDR-ICBT) forlocal Advanced cervical carcinoma.Methods and materials:This retrospective observational study was conducted from17th August2011to19th December2012at our hospital. Therewere59eligible patients contained in this study.The treatmentprotocol consisted of whole-pelvis external beamradiotherapy(EBRT) combined with High-Dose RateIntracavitary Brachytherapy and chemotherapy.EBRT had twoforms:three-dimensional conformal radiotherapy(3D-CRT) andIntensity Modulated Radiation Therapy(IMRT).EBRT wasdelivered to a total dose of45-50.4Gy in25-28fractions,anadditional boost of6-10Gy was given to the positive lymphnodes.The first HDR-ICBT was performed with in10days afterthe initial40Gy of EBRT.The applicator consisted of one curvedcentral tandem and two shielded ovoids.In total36Gy in6 fractions or42Gy in7fractions was given to point ‘A’ withtwo fractions per week.We completed the full course oftreatment within56days.The first chemotherapy was performedwithin1week after the start of EBRT,all patients receivedweekly cisplatin40mg/㎡during the course of radiotherapy,for5-6weeks.After the completion of treatment,patients wereregularly followed-up at our department until three years.The primary endpoint of this study was the3-year overallsurvival rate(OS) and the rectal and bladder complicationsrate.Results:Of the total of59patients,9(15.3%) developed localrecurrence.Overall three year pelvic control rate was84.7%.Six women developed distant metastasis.16patients(27.1%) died,the3-year overall survival rate was72.9%.The prevalence of grade1-3rectal acute toxicity andlate complication was22%、30.5%、1.7%and16.9%、8.5%、0%respectively.The prevalence of grade1-3bladder acutetoxicity and late complication was28.8%、10.2%、0%and11.9%、3.4%、3.4%respectively.Conclusion:External beam radiotherapy combined with high dose rate brachytherapy and weekly cisplatin chemotherapy is safe andeffective in the management of local advanced cervical cancer.