[Evaluation of high-dose-rate brachytherapy of the preoperative treatment of stage IB (FIGO) cervical carcinoma].
OBJECTIVE
Examination of stage IB (FIGO) cervical cancer patients treated with preoperative high dose rate brachytherapy (HDR BT) on the basis of specimen histology, local control and disease-free survival.


METHODS
Patients with stage IB cervical cancer were treated between 01/01/1993 and 31/1/1997 as part of complex treatment with HDR BT, the dose calculated for point A 2x5.5 Gy, with one week interval in the Municipal Centre of Oncoradiology, Uzsoki Hospital, Budapest. Different types of surgery were carried out in general within two weeks after preoperative HDR BT. Depending on the specimen histology, postoperative radiation treatment varied. In case of residual tumor vaginal BT 2x5.5 Gy was applied within a week; the dose was relevant to a tissue depth of 5 mm and to the upper third of vagina. This was followed by percutaneous irradiation (telecobalt, linear accelerator) at a dose of 50 Gy, box technique. In certain cases the para-aortal region was simultaneously irradiated. In case of negative specimen no postoperative vaginal HDR BT was applied in the majority of patients. Retrospective analysis helped to determine the effectiveness of regularly followed patients, as for local control and metastasis on the basis of the time of development of dissemination, respectively.


RESULTS
33.4% of 153 preoperatively treated patients had tumor-free specimen. Regular follow-up (at least 5 years) showed local relapse in 17 patients (11%), dissemination in 13 patients (8.4%), and 4 among them (2.6%) had simultaneous local relapse.


CONCLUSIONS
On the basis of our data it can be stated that preoperative HDR BT in stage IB cervical carcinoma decreased local relapse. In spite of negative specimen histology, vaginal HDR BT can be suggested, but if there is residual tumor, both HDR BT and percutaneous irradiation is suggested on the basis of our data.
Mayer
Arpád
A
Fôvárosi Onkoradiológiai Központ, Uzsoki utcai Kórház, Budapest 1145, Hungary. mayera@elender.hu
Nemeskéri
Csaba
C
Póti
Zsuzsa
Z
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis / Q000517:prevention & control / Q000532:radiotherapy; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery