High-dose-rate interstitial brachytherapy for previously untreated cervical carcinoma.
OBJECTIVE
The aim of the study was to evaluate the results of high-dose-rate interstitial brachytherapy (HDR-ISBT) for patients with advanced cervical carcinoma in which intracavitary radiation therapy may result in a suboptimal dose distribution.


METHODS
Between 1995 and 2005, 25 patients of median age 64 years were treated with external beam radiation therapy and HDR-ISBT. The International Federation of Gynecology and Obstetrics stages of the patients were I (4%), II (16%), III (68%), and IVA (12%). Whole pelvic irradiation of 30Gy/15 fractions was followed by HDR-ISBT of 30Gy/5 fractions/3 days. Subsequently, additional pelvic external beam radiation therapy of 20Gy/10 fractions was delivered with a midline block. The median followup period was 55 months.


RESULTS
The actuarial 5-year progression-free survival and overall survival rates for all cases were 42% and 54%, respectively. For the 17 patients with a Stage III tumor, the 5-year local control and overall survival rates were 73% and 51%, respectively. Two patients (8%) developed late toxicities of Grade 3.


CONCLUSIONS
A high rate of pelvic control and survival with acceptable level of late toxicities were obtained for patients with advanced cervical carcinoma treated with HDR-ISBT.
Isohashi
Fumiaki
F
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: isohashi@radonc.med.osaka-u.ac.jp.
Yoshioka
Yasuo
Y
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Koizumi
Masahiko
M
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Konishi
Koji
K
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Sumida
Iori
I
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Takahashi
Yutaka
Y
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Ogata
Toshiyuki
T
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Morishige
Ken-Ichirou
KI
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Enomoto
Takayuki
T
Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
Kawaguchi
Yoshifumi
Y
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Kotsuma
Tadayuki
T
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Adachi
Kana
K
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Fukuda
Shoichi
S
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Akino
Yuichi
Y
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Inoue
Takehiro
T
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D009367:Neoplasm Staging; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*