High dose rate versus low dose rate intracavity brachytherapy for locally advanced uterine cervix cancer

Abstract

This review showed no significant differences between HDR- and LDR-ICBT when considering OS, DSS, RFS, local control rate, recurrence, metastasis and treatment related complications for women with cervical carcinoma. Due to some potential advantages of HDR-ICBT (rigid immobilization, outpatient treatment, patient convenience, accuracy of source and applicator positioning, individualized treatment) we recommend the use of HDR-ICBT for all clinical stages of cervix cancer.

Empirical Evaluation of Very Large Treatment Effects of Medical Interventions

“…Finally, the reviewers also questioned the validity of very large survival benefits with ␤-agonists in threatened miscarriage, 22 different types of brachytherapies for stage I cervical cancer, 23 chaunxiong preparations to prevent stroke, 24 continuous vs intermittent infusion of loop diuretics in congestive heart failure, 25 and vitamin C in children with tetanus, 26 since their corresponding cumulative evidence was based on single small trials that were of very poor quality or (in the case of tetanus) apparently were not even a randomized controlled trial.…”

Inverse Planned High-Dose-Rate Brachytherapy for Locoregionally Advanced Cervical Cancer: 4-Year Outcomes

“…Although many of the landmark studies indicating the success of this combined therapy approach have used low-dose-rate (LDR) brachytherapy, several retrospective and prospective studies suggest high-dose-rate brachytherapy (HDRB) results in similar toxicity profiles and rates of local control (LC) (10)(11)(12)(13)(14)(15)(16). Although several potential practical advantages of HDRB have been posited, including shorter treatment times, reduced radiation exposure to health care workers, and patient convenience, one such advantage that holds promise for maximizing clinical efficacy while minimizing morbidity is the ability to deliver a wide range of dose distributions by altering the source dwell time through the use of a computer-controlled remote after system (17).…”

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

“…For instance, the LC in HDR BT studies ranged from 62% to 84% (10,75,78,79). And, the BT associated major complication rates can reach up to 10% (80)(81)(82) that may include fatality (1.4%) as reported by Ferrigno et al (78). These comparable results of EBRT and BT boost can be explained by the fact that, although the superiority of the BT physical dose distribution is undeniable (45), the implementation of a perfect brachytherapy implant is not devoid of limitations with high interfraction and interpractitioner variability.…”