title: High-dose-rate afterloading brachytherapy in carcinoma of the uterine cervix.
abstract: High-dose-rate (HDR) afterloading brachytherapy has been used at Mackay Memorial Hospital since 1984 for the treatment of gynecological malignancies. From October 1984 to October 1990, a total of 321 previously untreated patients with biopsy proven uterine cervical cancer were treated with radiation therapy with curative intent. According to FIGO staging, the patients were grouped into stage I (19 patients), stage IIA (13 patients), stage IIB (96 patients), stage III (158 patients) and stage IVA (35 patients). All patients received a combination of external beam irradiation plus intracavitary brachytherapy using the Buchler Remote Afterloading (RAL) system. For most cases, external beam irradiation using a Co-60 or Clinac 1800 photon beam (6 MV or 15 MV) of 3,060 cGy to 3,960 cGy was given to the whole pelvis (180 cGy/day, five days/week), followed by a midline shield after RAL. The total dose to the pelvic sidewall was 5,040 cGy to 5,400 cGy. The overall actuarial five-year survival rate was 55%. The total complication rate in a follow-up of two to eight years was 1% to 4%, and a good correlation existed between rectal complications and the calculated rectal dose. We conclude that fractionated HDR intracavitary therapy concurrent with teletherapy can achieve a high regional control rate with few complications, and can reduce the cost of hospitalization and the risk of anesthesia.
authors.affiliation: Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
authors.forename: J F
authors.initials: JF
authors.lastname: Chiou
authors.forename: M T
authors.initials: MT
authors.lastname: Liu
authors.forename: Y L
authors.initials: YL
authors.lastname: Lai
authors.forename: K H
authors.initials: KH
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*