title: Reirradiation with high-dose-rate remote afterloading brachytherapy implant in patients with locally recurrent or residual cervical carcinoma.
abstract: OBJECTIVE
  To assess the outcome for patients with postradiation locally recurrent or residual cervical malignancies treated with high-dose-rate (HDR) remote afterloading brachytherapy implant. This is a prospective study.
  
  
  METHODS
  Twenty-two patients with postradiation recurrent cervical carcinomas were treated with HDR interstitial brachytherapy. All of these 22 patients had received some form of radiotherapy prior to implant placement and had biopsy-proven recurrence. Implant dose for these patients was in the range of 12-45 Gy, with a median dose of 25.80 Gy.
  
  
  RESULTS
  Overall survival was better for patients in the 'no bad prognostic factor' (NBPF) group than for patients in the 'bad prognostic factor' (BPF) group and this difference was statistically significant. Overall survival was better for patients who had stage II disease before implant placement than for those who had stage III disease and also for patients who had relatively less parametrial disease. Grade 4 complications were seen only in four patients and were within acceptable limits. Multivariate analysis showed that only the BPF variable had a statistically significant effect on survival.
  
  
  CONCLUSIONS
  We conclude that reirradiation with HDR brachytherapy implant in recurrent or residual carcinoma cervix can give a good chance of survival, with acceptable morbidity, if proper selection of patients is done. This treatment should not be done for palliative purposes.
authors.affiliation: Gosavi Memorial, Siddhivinayak Ganpati Cancer Hospital, Miraj-Sangli Road, Miraj - 416 410, Maharashtra, India. dineshbadakh@yahoo.co.in
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Badakh
authors.forename: Amit H
authors.initials: AH
authors.lastname: Grover
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D018365:Neoplasm, Residual; D011829:Radiation Dosage; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*