Carcinoma of the uterine cervix. I. Impact of prolongation of overall treatment time and timing of brachytherapy on outcome of radiation therapy

Pérez, Carlos A.; Grigsby, Perry W.; Castro-Vita, Hernan; Lockett, Mary Ann

doi:10.1016/0360-3016(95)00220-s

Cited by 387 publications

(222 citation statements)

References 30 publications

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“…First, the overall treatment period is short. Several studies have shown that overall treatment time is a significant prognostic factor for patients with cervical cancer treated with radiation therapy alone (Fyles et al, 1992;Girinsky et al, 1993;Lanciano et al, 1993;Perez et al, 1995; Radiation therapy alone for carcinoma of the uterine cervix T Ota et al Delaloye et al, 1996). Fyles et al (1992) reported the influence of treatment duration on local control.…”

Section: Discussionmentioning

confidence: 99%

Treatment of squamous cell carcinoma of the uterine cervix with radiation therapy alone: long-term survival, late complications, and incidence of second cancers

et al. 2007

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The objective of this retrospective study was to determine the survival rate, incidence of late complications, and incidence of second cancers when radiation therapy alone is used for carcinoma of the uterine cervix. Between 1971 and 1995, 1495 patients with squamous cell carcinoma of the uterine cervix (stages I -IV) were treated with radiation therapy alone in our hospital. Radiation therapy consisted of a combination of high-dose-rate intracavitary brachytherapy and external beam radiotherapy. The cumulative 5-year survival rates for stages Ib, II, and III/IVa carcinoma were 93.5, 77.0, and 60.3%, respectively, and the 10-year survival rates were 90.9, 74.5, and 56.1%, respectively. Local control rates for stages Ib, II, and III/IVa carcinoma were 92.0, 79.4 and 64.2%, respectively. Eighty-two (5.5%) patients suffered grade III/IV or V (fatal) complications. A second cancer developed in 13 (0.87%) patients. Second cancers were observed most frequently in the rectum (five cases), colon (three cases), and uterine body (two cases). Long-term follow-up data revealed that our method of radiation therapy alone for locally advanced carcinoma of the uterine cervix is effective, with low incidences of late complications and second cancers.

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Section: Discussionmentioning

confidence: 99%

Treatment of squamous cell carcinoma of the uterine cervix with radiation therapy alone: long-term survival, late complications, and incidence of second cancers

et al. 2007

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“…Several studies have demonstrated a significant decrease in PC and OS rates when overall treatment time increased beyond 6 weeks. 27,28 In the conventional LDR treatment, the overall treatment time is usually 7-9 weeks. [22][23][24][25][26] In some HDR series, the overall treatment time was Ͼ 8 weeks, because 4 -5 fractions of HDR-ICBT were performed only after delivering 40 -45 Gy of EBRT.…”

Section: Discussionmentioning

confidence: 99%

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Nakano

Kato

Ohno³

et al. 2004

Cancer

144

100

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BACKGROUNDThe authors performed a long‐term follow‐up study to evaluate the efficacy and late toxicity of high‐dose rate intracavitary brachytherapy (HDR‐ICBT) for cervical carcinoma.METHODSFrom 1968 to 1986, 1148 patients with Stage IB to IVB squamous cell carcinoma of the cervix (staging was performed according to the International Federation of Gynecology and Obstetrics) were treated with a combination of external beam radiotherapy (EBRT) and HDR‐ICBT. For patients with early‐stage disease, 20 gray (Gy) of EBRT was delivered to the whole pelvis, followed by 24 Gy/4 fractions of HDR‐ICBT and 30 Gy of central‐shielding EBRT. For patients with advanced‐stage disease, 20–40 Gy of whole pelvic EBRT was administered, followed by 24 Gy/4 fractions of ICBT and 30–10 Gy of central‐shielding EBRT. The overall treatment time was approximately 6 weeks. Among survivors, the follow‐up rate was 98% and the median follow‐up duration was 22 years.RESULTSThe 10‐year pelvic tumor control rates were 93% for patients with Stage IB disease, 82% for patients with Stage II disease, and 75% for patients with Stage III disease. The 10‐year overall and cause‐specific survival rates were 74% and 89% for patients with Stage IB disease, 52% and 74% for patients with Stage II disease, and 42% and 59% for patients with Stage III disease, respectively. The 10‐year actuarial rates of major complications were 4.4% in the rectosigmoid colon, 0.9% in the bladder, and 3.3% in the small intestines.CONCLUSIONSThe results of the current study suggest that the combination of EBRT and HDR‐ICBT according to the authors' protocol provided outcomes that were comparable to those of the conventional low‐dose rate brachytherapy with acceptable rates of late complications in the treatment of cervical carcinoma. Cancer 2005. © 2004 American Cancer Society.

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“…Studies of the increase in tumor control dose with increasing treatment time suggest that after a variable lag period, surviving tumor clonogens regenerate rapidly during fractionated radiation therapy to the extent that each additional day of treatment requires *0.6 Gy, on average, to offset clonogenic cell regeneration, again suggesting a clonogenic cell doubling time of 3.5-5 days [5]. Many trials have conclusively proven overall treatment time to be a major determinant in the outcome in cervix cancer [6][7][8][9][10][11]. The usual recommendation is to complete treatment by 8 weeks (56 days) [12].…”

Section: Discussionmentioning

confidence: 99%

Pure Accelerated Radiation Versus Concomitant Chemoradiation in Selected Cases of Locally Advanced Carcinoma Cervix: A Prospective Study

Roy

Choudhury

Pal

et al. 2012

J Obstet Gynecol India

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Objective This non-randomized study was conducted to assess and compare the response and safety of true accelerated radiation alone to concomitant chemoradiation in locally advanced squamous cell carcinoma of the uterine cervix. Methods Sixty patients with locally advanced squamous cell carcinoma of the uterine cervix, FIGO Stages (2009) IB2-IIIB were non-randomized to receive six fractions per week of external beam radiation (EBRT) (will be henceforth referred to as Arm A or Study arm or pure accelerated radiation arm) and five fractions per week of EBRT and chemotherapy with inj cisplatin 40 mg/m 2 i.v. every

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Carcinoma of the uterine cervix. I. Impact of prolongation of overall treatment time and timing of brachytherapy on outcome of radiation therapy

Cited by 387 publications

References 30 publications

Treatment of squamous cell carcinoma of the uterine cervix with radiation therapy alone: long-term survival, late complications, and incidence of second cancers

Treatment of squamous cell carcinoma of the uterine cervix with radiation therapy alone: long-term survival, late complications, and incidence of second cancers

Long‐term results of high‐dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix

Pure Accelerated Radiation Versus Concomitant Chemoradiation in Selected Cases of Locally Advanced Carcinoma Cervix: A Prospective Study

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