title: Outcomes of high-dose-rate interstitial brachytherapy in the treatment of locally advanced cervical cancer: long-term results.
abstract: OBJECTIVE
  The purpose of this study was to determine locoregional control (LRC), disease-free survival (DFS), and toxicity of high-dose-rate interstitial brachytherapy (HDR-ISBT) in the treatment of locally advanced cervical cancer.
  
  
  METHODS
  Between March 1996 and May 2009, 116 patients with cervical cancer were treated. Of these, 106 (91%) patients had advanced disease (International Federation of Gynecology and Obstetrics stage IIB-IVA). Ten patients had stage IB, 48 had stage II, 51 had stage III, and 7 had stage IVA disease. All patients were treated with a combination of external beam radiation therapy (EBRT) to the pelvis (5040 cGy) and 2 applications of HDR-ISBT to a dose of 3600 cGy to the implanted volume. Sixty-one percent of patients also received interstitial hyperthermia, and 94 (81%) patients received chemotherapy.
  
  
  RESULTS
  Clinical LRC was achieved in 99 (85.3%) patients. Three-year DFS rates were 59%, 67%, 71%, and 57% for patients with stage IB, II, III, and IVA disease, respectively. The 5-year DFS and overall survival rates for the entire group were 60% and 44%, respectively. Acute and late toxicities were within acceptable limits.
  
  
  CONCLUSIONS
  Locally advanced cervical cancer patients for whom intracavitary BT is unsuitable can achieve excellent LRC and OS with a combination of EBRT and HDR-ISBT.
authors: Department of Radiation Oncology, University of California Irvine, Orange, California, USA.
authors: Melva
authors: M
authors: Pinn-Bingham
authors: Ajmel A
authors: AA
authors: Puthawala
authors: A M Nisar
authors: AM
authors: Syed
authors: Anil
authors: A
authors: Sharma
authors: Philip
authors: P
authors: Disaia
authors: Michael
authors: M
authors: Berman
authors: Krishnansu S
authors: KS
authors: Tewari
authors: Leslie
authors: L
authors: Randall-Whitis
authors: Usama
authors: U
authors: Mahmood
authors: Nilam
authors: N
authors: Ramsinghani
authors: Jeffrey
authors: J
authors: Kuo
authors: Wen-Pin
authors: WP
authors: Chen
authors: Christine E
authors: CE
authors: McLaren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D006979:Hyperthermia, Induced / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011859:Radiography; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage; D016896:Treatment Outcome; D047368:Tumor Burden; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D055815:Young Adult