title: Treatment outcome of medium-dose-rate intracavitary brachytherapy for carcinoma of the uterine cervix: comparison with low-dose-rate intracavitary brachytherapy.
abstract: OBJECTIVE
  To evaluate and compare the efficacy of medium-dose-rate (MDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for uterine cervical cancer.
  
  
  METHODS
  We evaluated 419 patients with squamous cell carcinoma of the cervix who were treated by radical radiotherapy with curative intent at Tokyo Women's Medical University from 1969 to 1999. LDR was used from 1969 to 1986, and MDR has been used since July 1987. When compared with LDR, fraction dose was decreased and fraction size was increased (1 or 2 fractions) for MDR to make the total dose of MDR equal to that of LDR. In general, the patients received a total dose of 60 to 70 Gy at Point A with external beam radiotherapy combined with brachytherapy according to the International Federation of Gynecology and Obstetrics stage. In the LDR group, 32 patients had Stage I disease, 81 had Stage II, 182 had Stage III, and 29 had Stage IVA; in the MDR group, 9 patients had Stage I disease, 19 had Stage II, 55 had Stage III, and 12 had Stage IVA.
  
  
  RESULTS
  The 5-year overall survival rates for Stages I, II, III, and IVA in the LDR group were 78%, 72%, 55%, and 34%, respectively. In the MDR group, the 5-year overall survival rates were 100%, 68%, 52%, and 42%, respectively. No significant statistical differences were seen between the two groups. The actuarial rates of late complications Grade 2 or greater at 5 years for the rectum, bladder, and small intestine in the LDR group were 11.1%, 5.8%, and 2.0%, respectively. The rates for the MDR group were 11.7%, 4.2%, and 2.6%, respectively, all of which were without statistical differences.
  
  
  CONCLUSIONS
  These data suggest that MDR ICBT is effective, useful, and equally as good as LDR ICBT in daytime (about 5 hours) treatments of patients with cervical cancer.
authors.affiliation: Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan. kaneyasu@hiroshimau.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kaneyasu
authors.forename: Midori
authors.initials: M
authors.lastname: Kita
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Okawa
authors.forename: Katsuya
authors.initials: K
authors.lastname: Maebayashi
authors.forename: Mari
authors.initials: M
authors.lastname: Kohno
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Sonoda
authors.forename: Hisae
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Nagata
authors.forename: Norio
authors.initials: N
authors.lastname: Mitsuhashi
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006441:Hemoglobin A / Q000032:analysis; D006801:Humans; D007421:Intestine, Small / Q000528:radiation effects; D008875:Middle Aged; D058958:Organs at Risk / Q000528:radiation effects; D011832:Radiation Injuries / Q000473:pathology; D011879:Radiotherapy Dosage; D012007:Rectum / Q000528:radiation effects; D015996:Survival Rate; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000528:radiation effects; D002583:Uterine Cervical Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D006441:Hemoglobin A