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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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3/2009
vol. 1
 
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Evaluation of HDR brachytherapy fraction dose on local control and complications rate in patients with cervical cancer IB and IIA

Sylwia Kellas-Sleczka
,
Brygida Białas
,
Marek Fijałkowski
,
Katarzyna Raczek-Zwierzycka

J Contemp Brachyther 2009; 1, 3: 187
Online publish date: 2009/10/08
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Purpose: The aim of this study was to evaluate of HDR-BT fraction dose on local control and complications rate in patients with cervical cancer IB and IIA treated with postoperative HDR-BT and external beam radiotherapy (EBRT).
Material and methods: From January 1996 to December 2002 in Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Gliwice Branch 150 patients with cervical cancer IB and IIA were treated with postoperative radiotherapy. All patients received EBRT (total dose: 46-54 Gy in 2 Gy or 1.8 Gy per fraction). They were divided into two groups according to fraction dose received in HDR-BT: group I: 5 Gy (twice a week to total dose 25 Gy) and group II: 7.5 Gy per fraction (twice a week to total dose 37.5). The reference point was 0.5 cm from the applicator surface. Acute and late radiation toxicity was evaluated according to EORTC/RTCG.
Results: In group I we observed severe acute radiation toxicity only in rectum in one case (2%). Late bladder radiation toxicity was observed only in grade I, late severe rectum complications were assessed in two patients (3.8%). In group II we observed severe acute radiation toxicity only in rectum in one case (1%). In group II two patients (2%) had late severe radiation reaction in bladder, and five patients (5%) in rectum. We observed statistically significant difference in frequency of late severe radiation toxicity in bladder (p < 0.05) and in rectum (p < 0.05) between group I and group II. Total number of local recurrences in our group was 11 (7.3%): one in group I and 10 cases in group II. There was no statistically significant difference in frequency of local recurrences between group I and II (p > 0.05).
Conclusions:
1. Higher fractionation doses in HDR-BT increase the total number of late severe complications in rectum and bladder.
2. The escalation of fractionation dose in HDR-BT does not result in better local control in women with cervical cancer IB and IIA.
3. In our experience 5 Gy per fraction in postoperative HDR-BT combined with EBRT is well tolerated and provides good local control.
Copyright: © 2009 Termedia Sp. z o. o. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
 
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