title: Image-guided brachytherapy (IGBT) combined with whole pelvic intensity-modulated radiotherapy (WP-IMRT) for locally advanced cervical cancer: a prospective study from Chiang Mai University Hospital, Thailand.
abstract: OBJECTIVE
  A report of preliminary results and toxicity profiles using image-guided brachytherapy (IGBT) combined with whole pelvic intensity-modulated radiation therapy (WP-IMRT) for locally advanced cervical cancer.
  
  
  METHODS
  Fifteen patients with locally advanced cervical cancer were enrolled into the study. WP-IMRT was used to treat the Clinical Target Volume (CTV) with a dose of 45 Gy in 25 fractions. Concurrent cisplatin (40 mg/m(2)) was prescribed during radiotherapy (RT) on weekly basis. IGBT using computed tomography was performed at the dose of 7 Gy × 4 fractions to the High-Risk Clinical Target Volume (HR-CTV).
  
  
  RESULTS
  The mean cumulative doses - in terms of equivalent dose of 2 Gy (EQD2) - of IGBT plus WP-IMRT to HR-CTV, bladder, rectum, and sigmoid colon were 88.3, 85.0, 68.2 and 73.6 Gy, respectively. In comparison with standard (point A prescription) dose-volume histograms, volume-based image-guided brachytherapy improved the cumulative doses for bladder of 67%, rectum of 47% and sigmoid of 46%. At the median follow-up time of 14 months, the local control, metastasis-free survival and overall survival rates were 93%, 100% and 93%, respectively. No grade 3-4 acute and late toxicities were observed.
  
  
  CONCLUSIONS
  The combination of image-guided brachytherapy and intensity-modulated radiotherapy improved the dose distribution to tumor volumes and avoided overdose in OARs which could be converted in excellent local control and toxicity profiles.
authors: The Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors: Ekkasit
authors: E
authors: Tharavichitkul
authors: Somsak
authors: S
authors: Wanwilairat
authors: Somvilai
authors: S
authors: Chakrabandhu
authors: Pitchayaponne
authors: P
authors: Klunklin
authors: Wimrak
authors: W
authors: Onchan
authors: Damrongsak
authors: D
authors: Tippanya
authors: Wannapa
authors: W
authors: Nopnop
authors: Razvan
authors: R
authors: Galalae
authors: Imjai
authors: I
authors: Chitapanarux
keywords: IGBT; IMRT; brachytherapy; cervical cancer
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