High-dose-rate remote afterloading intracavitary radiation therapy for cancer of the uterine cervix. A 20-year experience

Arai, Tatsuo; Nakano, Takashi; Morita, Shinroku; Sakashita, Kunio; Nakamura, Yuzuru; Fukuhisa, Kenjiro

doi:10.1002/1097-0142(19920101)69:1<175::aid-cncr2820690129>3.0.co;2-b

Cited by 146 publications

(47 citation statements)

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“…To achieve equivalent disease control to that achieved with LDR treatment without increasing the risk of late complications, various dosages and fractionation schedules of HDR-ICBT have been examined. Several studies, including nonrandomized [3][4][5][6][7][8][9] and randomized 10 -12 clinical trials, have demonstrated that HDR-ICBT was comparable to LDR-ICBT in terms of local control, survival, and morbidity rates. However, various fractionation schedules exist, and the optimum dose and fractionation schedule of ICBT and the appropriate combination of EBRT and ICBT remain controversial issues.…”

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confidence: 99%

“…However, to our knowledge there have been only a very few studies published to date in which disease status and late complications were monitored for Ͼ 10 years after treatment, although HDR-ICBT has been used extensively in Asia and Europe for Ͼ 3 decades. [3][4][5][7][8][9][10][11][12] Therefore, the safety of HDR treatment has not been investigated thoroughly.…”

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confidence: 99%

“…The treatment results were reported in 1992. 4 The current study updates the previous publication and provides follow-up results covering Ͼ 20 years.…”

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confidence: 99%

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

Nakano

Kato

Ohno³

et al. 2004

Cancer

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

Nakano

Kato

Ohno³

et al. 2004

Cancer

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“…HDR proved to be as clinically effective as LDR in the management of cervical cancer. In rates of survival, relapse and complications, no statistically significant differences have been found between both treatment methods 2,3,4,14,15,16,17 .…”

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confidence: 89%

Brachytherapy for stage IIIB squamous cell carcinoma of the uterine cervix: survival and toxicity

Zuliani¹,

Cunha²,

Esteves³

2010

Rev. Assoc. Med. Bras.

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SummaryObjective. To compare survival and toxicity of three different treatments for stage IIIB cervix cancer: low-dose-rate (LDR), high-dose-rate (HDR) brachytherapy and association of HDR and chemotherapy. MethOds. Between 1985 and 2005, 230 patients with FIGO stage IIIB squamous cell carcinoma of the uterine cervix received 4-field pelvic teletherapy at doses between 40 and 50.4 Gy, with a different complementation in each group. The LDRB group, with 42 patients, received one or two insertions of LDR, with Cesium-137, in a total dose of 80 to 100Gy at point A. The HDR group, 155 patients received HDR in 4 weekly 7 Gy fractions and 9 Gy to 14.4 Gy applied to the involved parametria. The CHT group, 33 patients, were given the same treatment as the HDR group and received 5 or 6 weekly cycles of cisplatin, 40 mg per m2. Results. The five-year progression-free survival (PFS) was 60% for the HDR group and 45% for the LDR group, and the two-year PFS for the CHT group was 65% (p = 0.02). The five-year Overall Survival (OS) was 65% for the HDR group and 49% for the LDR group. The two-year OS was 86% for the CHT group (p = 0.02). Rectum toxicity grade II was 7% for the LDR group, 4% for the HDR group and 7% for the CHT group that had one case of rectum toxicity grade IV. cOnclusiOn. Patients that received HDR had better OS and PFS. The Chemotherapy-HDR association showed no benefit when compared to HDR only. Toxicity rates showed no difference between the three groups.

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“…Details of IV 7 the protocol have been reported elsewhere. 18 Gy. Along with the central shielding irradiation, these Total 64 patients also received intracavitary irradiation by remote afterloading system using 60 Co sources; they received 4 insertions (1 per week) with fraction doses of 550 Centigray (cGy) to 600 cGy at point A.…”

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Correlation of cervical carcinoma c-erb B-2 oncogene with cell proliferation parameters in patients treated with radiation therapy for cervical carcinoma

Nakano¹,

Oka²,

Ishikawa³

et al. 1997

Cancer

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BACKGROUND. Although c-erb B-2 oncoprotein expression (CerbB-OPE) is believedTakashi Nakano, M.D.to be associated with tumor cell proliferation and prognosis, the correlation beKuniyuki Oka, M.D.tween CerbB-OPE and cell proliferation parameters has not been fully analyzed.Atsuko Ishikawa, M.D. METHODS.Immunohistochemical studies were performed on 64 cervical carcinoma Shinroku Morita, M.D.patients treated with radiation therapy. Prognosis was analyzed by CerbB-OPE, growth fraction determined with Ki-67 immunohistochemistry (Ki-GF), and the Division of Radiation Medicine, National Instimitotic index of proliferating cell population (pMI). tute of Radiological Sciences, Chiba, Japan. RESULTS.CerbB-OPE was observed on the cell membrane of carcinoma cells. Positivity of CerbB-OPE, which was 42.4% in total, increased significantly with stage progression. No significant differences were observed among histologic subtypes.Mean total Ki-GF and pMI were 36% and 2.5%, respectively. Mean Ki-GF for CerbB(/) patients was 26.2%, which was significantly lower than the 38.3% for CerbB(0) patients (P õ 0.01). The mean pMI for CerbB(/) patients was 3.7%, which was significantly higher than the 2% for CerbB(0) patients (P õ 0.05). The 5-year survival rates of CerbB(/) patients and CerbB(0) patients were 45.1% and 75.6%, respectively, indicating that CerbB(/) patients showed significantly poorer survival than CerbB(0) patients (P õ 0.01). The difference in survival was due mainly to local recurrence rather than distant metastasis. There were significant correlations between prognosis and Ki-GF and pMI. CONCLUSIONS.The poor prognosis of patients with cervical carcinoma with CerbB-OPE was due to local recurrences after radiation therapy. The correlations of CerbB-OPE with Ki-GF and pMI suggest that c-erb B-2 oncoprotein may play an important role in the cell proliferation status of cervical carcinoma.

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High-dose-rate remote afterloading intracavitary radiation therapy for cancer of the uterine cervix. A 20-year experience

Cited by 146 publications

References 14 publications

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

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

Brachytherapy for stage IIIB squamous cell carcinoma of the uterine cervix: survival and toxicity

Correlation of cervical carcinoma c-erb B-2 oncogene with cell proliferation parameters in patients treated with radiation therapy for cervical carcinoma

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