title: HDR brachytherapy combined with interstitial hyperthermia in locally advanced cervical cancer patients initially treated with concomitant radiochemotherapy: a phase I study.
abstract: OBJECTIVE
  The aim of this study was to investigate whether hyperthermia (HT) combined with interstitial brachytherapy (ISBT) has any influence on acute and late side effects in patients with advanced cervical cancer. Local control (LC) and disease-free survival (DFS) were also analysed.
  
  
  METHODS
  Following the completion of radiochemotherapy, patients with cervical cancer (FIGO stages I-III) were assigned to two treatment groups, either ISBT combined with interstitial hyperthermia (ISHT) or ISBT alone as a control group. Selection criterion for the ISBT combined with HT group was advanced cervical cancer with poor response to external beam radiotherapy. A total of 76 patients were included in the statistical analysis. Once a week, HT (at a temperature above 42.5°C) was administered for 45 min before and during high dose rate (HDR) brachytherapy (BT) in 43 patients. Four HT treatments were administered.
  
  
  RESULTS
  The median follow-up time was 43 months (range 4-73 months). Significant differences were not observed for the distribution of early and late complications between the HT and no HT groups. Despite this, LC was similar in both groups. The 5-year DFS for the BT and BT + HT groups was 73.6% and 65.8%, respectively. The 5-year LC for the BT and BT + HT groups was 89% and 83%, respectively. For the majority of patients the maximum temperature level of 44-45°C was achieved during the ISHT.
  
  
  CONCLUSIONS
  ISHT is well tolerated and does not affect treatment-related early or late complications.
authors.affiliation: Department of Brachytherapy, Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgena Street 5, Warsaw, Poland. agnieszka.zolciak@wp.pl
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Zolciak-Siwinska
authors.forename: Joanna
authors.initials: J
authors.lastname: Jonska-Gmyrek
authors.forename: Jagna
authors.initials: J
authors.lastname: Staniaszek
authors.forename: Norbert
authors.initials: N
authors.lastname: Piotrkowicz
authors.forename: Wojciech
authors.initials: W
authors.lastname: Michalski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000628:therapy*; D055815:Young Adult