title: Concurrent Chemoradiotherapy without Brachytherapy in Locally Advanced Cervical Cancer.
abstract: BACKGROUND
  Concurrent chemoradiotherapy (EBRT + cisplatin) plus intracavitary brachytherapy is the standard of care in patients with advanced cervical cancer. However, a number of patients could not undergone brachytherapy due to massive residual tumor or anatomical distortion. In this study, we have evaluated the treatment outcome in patients with locally advanced cervical cancer, undergone conventional EBRT plus cisplatin based chemotherapy.
  
  
  METHODS
  IN THIS STUDY, WE HAVE SELECTED PATIENTS WITH LOCALLY ADVANCED CERVICAL CARCINOMA (STAGE: IIB to IIIB) undergone external beam radiotherapy and chemotherapy without brachytherapy at our institute between October of 2007 and October of 2009. The patients have received 50 Gy within 5 weeks to whole pelvic that has followed by a localized boost dose on tumor to 70 Gy concurrently with cisplatin 35 mg/m2 weekly. The treatment has related toxicities, and survival (overall and disease free) have evaluated.
  
  
  RESULTS
  30 cases with a median age of 55 (range; 40 to 73) have been studied. According to FIGO classification, the clinical stages were as follows: stage: IIB 23, IIIA 4, and IIIB 3 cases. Three months after treatment, 19 patients (63.3%) have achieved complete response. With a median follow up time of 18 months (range; 10-33 months), 8/23 cases (34.7%) with stage IIB and 2/7 (28.5%) among stage IIIA-IIIB remained disease free at the end of follow up. Data have shown a 2-year overall survival rate of 58.7% ± 9% and 2- year disease free survival of 37.7% ± 9% . Most toxicities were grade I and II. 2 (6.6%) grade III diarrhea and 4 (13.3%) grade III neutropenia have recorded.
  
  
  CONCLUSIONS
  Although a considerable number of patients have achieved complete response using concurrent chemoradiotherapy without brachytherapy, the overall treatment outcomes especially for stage IIIA-IIIB were unsatisfactory. Using modern radiation therapy techniques with increased delivered boost dose could improve treatment results.
authors.affiliation: Women's Health Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Sima
authors.initials: S
authors.lastname: Kadkhodayan
authors.affiliation: Solid Tumor Treatment Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Homaei Shandiz
authors.affiliation: Solid Tumor Treatment Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Seilanian Toussi
authors.affiliation: Dept. of Epidemiology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Monavar
authors.initials: M
authors.lastname: Afzal Aghaee
authors.affiliation: Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Farnoosh
authors.initials: F
authors.lastname: Farshidi
authors.affiliation: Dept. of Radiation Oncology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Parvane
authors.initials: P
authors.lastname: Dehghan
keywords: Cervical cancer; Concurrent chemoradiotherapy; Radiotherapy