title: Clinical outcomes and toxicity of postoperative intensity-modulated versus three-dimensional conformal radiation therapy in patients with cervical cancer.
abstract: OBJECTIVE
  To compare the clinical outcomes and toxicity of pelvic intensity-modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3D-CRT) as adjuvant postoperative treatment in patients with cervical cancer.
  
  
  METHODS
  Between April 2008 and December 2013, 115 patients with International Federation of Gynecology and Obstetrics stages IA-IIB cervical cancer were initially treated with radical hysterectomy and underwent adjuvant pelvic external-beam radiation therapy (EBRT) without brachytherapy. The median postoperative pelvic EBRT dose was 50 Gy (range, 45-50 Gy). Twenty-six patients received IMRT and 89 patients underwent 3D-CRT. Chemotherapy consisted of two to four courses of platinum-based treatment. Locoregional control, disease-free survival (DFS), overall survival (OS) and treatment-related complications were compared between the two groups. No significant difference in clinical data was observed between groups.
  
  
  RESULTS
  With a median follow-up of 28.6 months, 2-year OS rates were 90.3% in the 3D-CRT group and 91.6% in the IMRT group (P = 0.674), and DFS rates were 88.8% and 86.0%, respectively (P = 0.722). The rates of acute gastrointestinal (GI) and genitourinary (GU) toxicity were lower in the IMRT group than in the 3D-CRT group (GI, 50% vs 84.3%, P = 0.009; GU, 19.2% vs 56.2%, P = 0.007).
  
  
  CONCLUSIONS
  Our results indicate that IMRT not only significantly reduced the rate of toxicity, but also provided good clinical outcomes consistent with those achieved with 3D-CRT. However, further studies with more patients and longer follow-up times are warranted to confirm the benefits of IMRT.
authors.affiliation: Cancer Center, Institute of Surgical Research, Daping Hospital, The Military Medical University, Chongqing, China.
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Lan
authors.affiliation: Cancer Center, Institute of Surgical Research, Daping Hospital, The Military Medical University, Chongqing, China.
authors.forename: Xian
authors.initials: X
authors.lastname: Yu
authors.affiliation: Cancer Center, Institute of Surgical Research, Daping Hospital, The Military Medical University, Chongqing, China.
authors.forename: He
authors.initials: H
authors.lastname: Xiao
authors.affiliation: Cancer Center, Institute of Surgical Research, Daping Hospital, The Military Medical University, Chongqing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zhou
authors.affiliation: Cancer Center, Institute of Surgical Research, Daping Hospital, The Military Medical University, Chongqing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Hu
authors.affiliation: Cancer Center, Institute of Surgical Research, Daping Hospital, The Military Medical University, Chongqing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.affiliation: Cancer Center, Institute of Surgical Research, Daping Hospital, The Military Medical University, Chongqing, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D041981:Gastrointestinal Tract / Q000528:radiation effects*; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D011832:Radiation Injuries / Q000209:etiology*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D015996:Survival Rate; D014566:Urogenital System / Q000528:radiation effects*; D002583:Uterine Cervical Neoplasms / Q000628:therapy*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds
keywords: cervical cancer; intensity-modulated radiotherapy; postoperative; three-dimensional conformal radiotherapy; toxicity