title: A single institutional experience with definitive radiotherapy for cervical cancer using both high- and low-dose-rate brachytherapy.
abstract: OBJECTIVE
  To evaluate outcomes in cervical cancer patients treated with high-dose-rate (HDRB) or low-dose-rate (LDRB) brachytherapy.
  
  
  METHODS
  A retrospective chart review compared control rates, survival, and complications in the two groups.
  
  
  RESULTS
  All patients received pelvic EBRT (45 Gy/5 weeks). 106 patients receiving LDRB were compared to 107 treated with HDRB. The median point A LDRB and HDRB dose was 42 Gy and 25 Gy/5, respectively. Tumor size and stage (I(B) 23% LDRB, 30% HDRB, II(A) 22% LDRB, 11% HDRB, II(B) 44% LDRB, 48% HDRB, III(B) 11% LDRB and HDRB) were similar, but more HDRB patients received chemosensitization (44% versus 6%). After adjusting for lymph node status with cox regression, no difference in 5-year survival (53% HDRB and 61% LDRB P = 0.088) or 5-year DFS (54% both groups, P = 0.089) was found between the two groups. Local recurrences occurred in 19% of the LDRB and 5% of the HDRB cohort. The time to LR was significantly longer in the HDRB group, and this persisted after adjusting for the increased used of chemotherapy in these patients. There was no significant difference in grade III or IV toxicity (6.6% LDRB and 3.7% HDRB).
  
  
  CONCLUSIONS
  This HDRB dose fractionation schedule yielded improved local control but similar survival compared to LDRB.
authors.affiliation: University of Pittsburgh Cancer Institute, Department of Radiation Oncology, UPMC Cancer Pavilion, Room 534 Fifth Floor, 5150 Centre Avenue, Pittsburgh, PA 15232, USA. Gersztenk@upmc.edu
authors.forename: Kristina
authors.initials: K
authors.lastname: Gerszten
authors.forename: William E
authors.initials: WE
authors.lastname: Gooding
authors.forename: Yan
authors.initials: Y
authors.lastname: Lin
authors.forename: Dwight E
authors.initials: DE
authors.lastname: Heron
authors.forename: Clare
authors.initials: C
authors.lastname: Faul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy*