title: [Complete pathologic remission after preoperative high-dose brachytherapy in patients with operable cervical cancer: preliminary results of a prospective randomized study].
abstract: The purpose of the study was a preliminary evaluation of the efficacy of preoperative intracavitary high-dose-rate brachytherapy (HDR BT) in sterilization of the specimen of operable cervical cancer patients enrolled into a prospective, randomized study. Between 2005 and 2010, 100 operable cervical cancer patients of FIGO stage I/A2 (n=4), I/B1 (n=51), I/B2 (n=19), IIA (n=17), and proximal II/B (n=9) were randomized in two arms: in arm "A" (n=50) allocated treatment was 2x8 Gy preoperative intracavitary HDR BT followed by radical surgery, in arm "B" (n= 50) no preoperative treatment was given before the planned radical Wertheim hysterectomy. The rates of pathologic complete remission (pCR) were compared using the Fisher-exact test. In arm "A" 41 patients (82%), in arm "B" 42 patients (84%) underwent radical hysterectomy. The rate of pCR after preoperative BT was 26.8% (11/41), while in the control group the specimen was free of tumor in 7.1% (3/42; p=0.0204). Preoperative HDR BT for cervical cancer patients significantly increases the rate of pathologically tumor-free specimens. Longer follow-up is needed to evaluate the impact of pCR on local tumor control and survival. Our preliminary results support further enrollment of patients into our randomized clinical trial.
authors.affiliation: Sugárterápiás Központ, Országos Onkológiai Intézet, Budapest, Hungary. j.keleti@oncol.hu
authors.forename: Júlia
authors.initials: J
authors.lastname: Vízkeleti
authors.forename: Imre
authors.initials: I
authors.lastname: Pete
authors.forename: Ildikó
authors.initials: I
authors.lastname: Vereczkey
authors.forename: Georgina
authors.initials: G
authors.lastname: Fröhlich
authors.forename: Katalin
authors.initials: K
authors.lastname: Horváth
authors.forename: Szilvia
authors.initials: S
authors.lastname: Varga
authors.forename: Tamás
authors.initials: T
authors.lastname: Pulay
authors.forename: Miklós
authors.initials: M
authors.lastname: Kásler
authors.forename: Csaba
authors.initials: C
authors.lastname: Polgár
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery