title: Twice-per-day fractionated high versus continuous low dose rate intracavitary therapy in the radical treatment of cervical cancer: a nonrandomized comparison of treatment results.
abstract: OBJECTIVE
  To compare the efficacy of two twice-per-day fractionated high dose rate (HDR) brachytherapies with a historical control group treated with low dose rate (LDR) brachytherapy for cervical cancer patients.
  
  
  METHODS
  From 1985 to 1988, 92 patients with cancer of the cervic were treated by remote-controlled, HDR brachytherapy, six fractions of 7 Gy per fraction (42 Gy) at point A (HDR-6). Fifty-seven patients were treated with four fractions of 8 Gy per fraction (32 Gy) at point A (HDR-4). A twice-per-day program was used for all HDR patients by two split courses. As a historical control, treatment results of 259 patients treated with LDR brachytherapy (40 Gy in two split courses) were compared with those of the two HDR regimens. All patients received whole pelvic external irradiation, 36-45 Gy (mostly 40 Gy) before brachytherapy.
  
  
  RESULTS
  Five-year local control rates were not significantly different for the three groups (HDR-6 = 82.0%, HDR-4 = 85.5%, and LDR = 89.5%, respectively). Five-year survival rates were also comparable (67.7%, 77.9%, and 74.1%, respectively). However, late complications were lower in HDR-4 than HDR-6 (11.0% vs. 25.6%).
  
  
  CONCLUSIONS
  Both 5-year local control and survival rates were comparable among the three groups. However, HDR-4, which was more biologically equivalent to our LDR regimen, showed fewer complications compared to HDR-6. In addition, our twice-per-day schedule shortened the hospital stay.
authors.affiliation: Department of Radiation Oncology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China.
authors.forename: W L
authors.initials: WL
authors.lastname: Hsu
authors.forename: C J
authors.initials: CJ
authors.lastname: Wu
authors.forename: Y M
authors.initials: YM
authors.lastname: Jen
authors.forename: S H
authors.initials: SH
authors.lastname: Yen
authors.forename: K T
authors.initials: KT
authors.lastname: Lin
authors.forename: L P
authors.initials: LP
authors.lastname: Ger
authors.forename: R Y
authors.initials: RY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011832:Radiation Injuries / Q000453:epidemiology; D011879:Radiotherapy Dosage; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*