title: Stereotactic body radiation therapy via helical tomotherapy to replace brachytherapy for brachytherapy-unsuitable cervical cancer patients - a preliminary result.
abstract: OBJECTIVE
  To review the experience and to evaluate the results of stereotactic body radiation therapy (SBRT) via helical tomotherapy (HT), for the treatment of brachytherapy-unsuitable cervical cancer.
  
  
  METHODS
  Between September 1, 2008 to January 31, 2012, nine cervical cancer patients unsuitable for brachytherapy were enrolled. All of the patients received definitive whole pelvic radiotherapy with or without chemotherapy, followed by SBRT via HT.
  
  
  RESULTS
  The actuarial locoregional control rate at 3 years was 78%. The mean biological equivalent dose in 2-Gy fractions of the tumor, rectum, bladder, and intestines was 76.0 ± 7.3, 73.8 ± 13.2, 70.5 ± 10.0, and 43.1 ± 7.1, respectively. Only two had residual tumors after treatment, and the others were tumor-free. Two patients experienced grade 3 acute toxicity: one had diarrhea; and another experienced thrombocytopenia. There were no grade 3 or 4 subacute toxicities. Three patients suffered from manageable rectal bleeding in months 11, 14, and 25, respectively. One stage I VA patient experienced fistula formation in month 3.
  
  
  CONCLUSIONS
  SBRT via HT provides the possibility for treatment of locally advanced cervical cancer in patients who are unsuitable for brachytherapy. Long-term follow up and enrollment of more such patients to receive SBRT via the HT technique are warranted.
authors: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan; ; Department of Medicine ; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan;
authors: Chen-Hsi
authors: CH
authors: Hsieh
authors: Hui-Ju
authors: HJ
authors: Tien
authors: Sheng-Mou
authors: SM
authors: Hsiao
authors: Ming-Chow
authors: MC
authors: Wei
authors: Wen-Yih
authors: WY
authors: Wu
authors: Hsu-Dong
authors: HD
authors: Sun
authors: Li-Ying
authors: LY
authors: Wang
authors: Yen-Ping
authors: YP
authors: Hsieh
authors: Yu-Jen
authors: YJ
authors: Chen
authors: Pei-Wei
authors: PW
authors: Shueng
keywords: biological equivalent dose; complication; image guidance; intensity modulated radiation therapy; rectal bleeding
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