title: Long-term results of high-dose rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix.
abstract: BACKGROUND
  The 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.
  
  
  METHODS
  From 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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Department of Radiology and Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakano
authors.forename: Shingo
authors.initials: S
authors.lastname: Kato
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ohno
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tsujii
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Sato
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Fukuhisa
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Arai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy*