title: High-dose-rate brachytherapy and concurrent chemoradiotherapy followed by surgery for stage Ib-IIb cervical cancer: single institution experience.
abstract: BACKGROUND
  There are still controversies about the benefit of surgery after concurrent radiochemotherapy (CRT) for locally advanced cervical cancer. The aim of this study was to evaluate toxicity, local tumor control and overall survival of surgery after CRT in stage IB-IIB cervical cancer.
  
  
  METHODS
  Between 2002 and 2008, 24 patients with stage IB-IIB cervical cancer were treated with external-beam radiotherapy concomitantly with chemotherapy. High-dose rate brachytherapy fractions were given once weekly. Radical hysterectomy was undertaken after a median of 42 days.
  
  
  RESULTS
  Overall survival at five years was estimated at 75% (95% confidence interval=52-88%) and sustained thereafter through to 8.9 years. No patient experienced local failure in the surgical bed. Postoperative complications were recorded in two patients.
  
  
  CONCLUSIONS
  Surgery after CRT in stage IB-IIB cervical cancer is safe and leads to better local control of the disease and overall survival.
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia afrobe@irb.hr.
authors: Ana
authors: A
authors: Fröbe
authors: Department of Radiation Oncology, University of Toronto, Credit Valley Hospital, Mississauga, ON, Canada.
authors: Glenn
authors: G
authors: Jones
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Tomislav
authors: T
authors: Bokulić
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Iva
authors: I
authors: Mrčela
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Mirjana
authors: M
authors: Budanec
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Jure
authors: J
authors: Murgić
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Blanka
authors: B
authors: Jakšić
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Marin
authors: M
authors: Prpić
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Ante
authors: A
authors: Bolanča
authors: Department of Oncology and Nuclear Medicine, University Hospital Sestre milosrdnice, Zagreb, Croatia.
authors: Zvonko
authors: Z
authors: Kusić
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods; D059186:Chemoradiotherapy, Adjuvant; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*
keywords: Cervical cancer; concomitant chemoradiotherapy; high-dose-rate brachytherapy; surgery