title: Radiation therapy for carcinoma of the uterine cervix: comparison of two brachytherapy schedules.
abstract: We compared the survival rates and late effects for two groups of cervical cancer patients treated with almost the same external radiotherapy but different remote afterloading systems (RALS) for high-dose-rate intracavitary radiation therapy regimens. A total of 218 patients with carcinoma of the uterine cervix were treated. For 98 patients, intracavitary brachytherapy was delivered with 6-7.5 Gy/fraction to Point A (Group A), and for 120, 5 Gy/fraction with a modified source step size (Group B). The 3-year cause-specific survival rates by stage and treatment schedule were Group A: 91% and Group B: 96% in Stage I, 89% and 92% in Stage II, 64% and 75% in Stage III, 44% and 69% in Stage IV. The survival curves did not reveal any statistically significant differences at any stage. The 3-year cumulative local failure rates were 14% in Group A and 7% in Group B (P = 0.1202), while the actuarial rates of developing rectal complication (Grade 2 or more) at 3 years were 25% in Group A and 4% in Group B (P < 0.0001). This retrospective analysis suggests that a low dose per fraction with modified source step size is advantageous because of yielding almost the same local control but with fewer rectal complications.
authors.affiliation: Department of Radiation Oncology, Osaka Rosai Hospital, 1179-3 Nagasone-cyo, kita-ku, Sakai, Osaka, Japan chatani808@hotmail.com.
authors.forename: Masashi
authors.initials: M
authors.lastname: Chatani
authors.affiliation: Department of Radiation Oncology, Osaka Rosai Hospital, 1179-3 Nagasone-cyo, kita-ku, Sakai, Osaka, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Tsuboi
authors.affiliation: Department of Radiation Oncology, Osaka Rosai Hospital, 1179-3 Nagasone-cyo, kita-ku, Sakai, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yagi
authors.affiliation: Department of Radiation Oncology, Osaka Rosai Hospital, 1179-3 Nagasone-cyo, kita-ku, Sakai, Osaka, Japan.
authors.forename: Kanta
authors.initials: K
authors.lastname: Fujiwara
authors.affiliation: Department of Radiation Oncology, Osaka Rosai Hospital, 1179-3 Nagasone-cyo, kita-ku, Sakai, Osaka, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Tachimoto
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008875:Middle Aged; D012007:Rectum / Q000528:radiation effects; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy*
keywords: RALS; carcinoma; high dose rate; uterine cervix