title: High dose three-dimensional conformal boost using the real-time tumor tracking radiotherapy system in cervical cancer patients unable to receive intracavitary brachytherapy.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the clinical results of treatment with a high dose of 3-dimensional conformal boost (3DCB) using a real-time tracking radiation therapy (RTRT) system in cervical cancer patients.
  
  
  METHODS
  Between January 2001 and December 2004, 10 patients with cervical cancer were treated with a high dose 3DCB using RTRT system. Nine patients received whole pelvis radiation therapy (RT) with a median dose of 50 Gy (range, 40-50 Gy) before the 3DCB. The median dose of the 3DCB was 30 Gy (range, 25-30 Gy). Eight patients received the 3DCB twice a week with a daily fraction of 5 Gy. The determined endpoints were tumor response, overall survival, local failure free survival, and distant metastasis free survival. The duration of survival was calculated from the time of the start of radiotherapy.
  
  
  RESULTS
  All patients were alive at the time of analysis and the median follow-up was 17.6 months (range, 4.9-27.3 months). Complete response was achieved in nine patients and one patient had a partial response. The 1- and 2-year local failure free survival was 78.8% and 54%, respectively. The 1- and 2-year distant metastasis free survival was 90% and 72%, respectively. Late toxicity of a grade 2 rectal hemorrhage was seen in one patient. A subcutaneous abscess was encountered in one patient.
  
  
  CONCLUSIONS
  The use of the high dose 3DCB in the treatment of cervical cancer is safe and feasible where intracavitary brachytherapy (ICBT) is unable to be performed. The escalation of the 3DCB dose is currently under evaluation.
authors.affiliation: Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Park
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Akio
authors.initials: A
authors.lastname: Yonesaka
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Tsuchiya
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ebina
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Taguchi
authors.forename: Norio
authors.initials: N
authors.lastname: Katoh
authors.forename: Rumiko
authors.initials: R
authors.lastname: Kinoshita
authors.forename: Masayori
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011880:Radiotherapy Planning, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*