title: An early report on outcomes from computed tomographic-based high-dose-rate brachytherapy for locally advanced cervix cancer: A single institution experience.
abstract: OBJECTIVE
  To report our experience using high-dose-rate (HDR) brachytherapy with computed tomographic (CT) imaging for locally advanced cervix cancer, using available resources to optimize the treatment.
  
  
  METHODS
  Fifty-seven women with cervix cancer were treated between September 2004 and March 2008. Patients received external radiotherapy, HDR brachytherapy (7 Gy x4) and concurrent chemotherapy. CT planning was done for each insertion.
  
  
  RESULTS
  Median age was 53 years (range, 29-89 years); majority (49%) had International Federation of Gynecology and Obstetrics stage IIB. The median follow-up was 22.6 months. There were 4 patients who required laser coagulation for rectal bleeding, and one patient required hemicolectomy for sigmoid stricture. There was no grade 3 or 4 genitourinary toxicity. The Kaplan-Meier overall survival, relapse free, central pelvic and pelvic control at 3 years was 86%, 62%, 89%, and 83%, respectively. Pelvic control for tumors 2 to 5 cm was 95% and 84% for tumors greater than 5 cm.
  
  
  CONCLUSIONS
  Our early experience confirms that CT-based HDR brachytherapy for cervix cancer achieves disease control comparable to other published series. At the same time, conformal avoidance of organs at risk allows for low rates of toxicity.
authors.affiliation: Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada. Electronic address: ahallock@uwo.ca.
authors.forename: Abhirami
authors.initials: A
authors.lastname: Hallock
authors.affiliation: Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Surry
authors.affiliation: Odette Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Deidre
authors.initials: D
authors.lastname: Batchelar
authors.affiliation: Odette Cancer Centre, Toronto, Ontario, Canada; Providence Saint Joseph Medical Center, Burbank, California.
authors.forename: Lauren
authors.initials: L
authors.lastname: Vanderspek
authors.affiliation: Providence Saint Joseph Medical Center, Burbank, California.
authors.forename: Jasper
authors.initials: J
authors.lastname: Yuen
authors.affiliation: Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Hammond
authors.affiliation: Peel Regional Cancer Centre, Mississauga, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Radwan
authors.affiliation: Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Yaremko
authors.affiliation: Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada.
authors.forename: George
authors.initials: G
authors.lastname: Rodrigues
authors.affiliation: Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: D'Souza