title: The role of interstitial brachytherapy in the management of primary radiation therapy for uterine cervical cancer.
abstract: OBJECTIVE
  The aim of this study was to report the clinical results of uterine cervical cancer patients treated by primary radiation therapy including brachytherapy, and investigate the role of interstitial brachytherapy (ISBT).
  
  
  METHODS
  All consecutive uterine cervical cancer patients who were treated by primary radiation therapy were reviewed, and those who were treated by ISBT were further investigated for clinical outcomes and related toxicities.
  
  
  RESULTS
  From December 2008 to October 2014, 209 consecutive uterine cervical cancer patients were treated with primary radiation therapy. Among them, 142 and 42 patients were treated by intracavitary and hybrid brachytherapy, respectively. Twenty-five patients (12%) were treated by high-dose-rate (HDR)-ISBT. Five patients with distant metastasis other than para-aortic lymph node were excluded, and 20 patients consisted of the analysis. Three-year overall survival (OS), progression-free survival (PFS), and local control (LC) rate were 44.4%, 38.9%, and 87.8%, respectively. Distant metastasis was the most frequent site of first relapse after HDR-ISBT. One and four patients experienced grade 3 and 2 rectal bleeding, one grade 2 cystitis, and two grade 2 vaginal ulcer.
  
  
  CONCLUSIONS
  Feasibility and favorable local control of interstitial brachytherapy for locally advanced cervical cancer was demonstrated through a single institutional experience with a small number of patients.
authors.affiliation: Department of Radiation Oncology.
authors.forename: Naoya
authors.initials: N
authors.lastname: Murakami
authors.affiliation: Department of Radiation Oncology.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Gynecologic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Radiation Oncology.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Department of Radiation Oncology.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Wakita
authors.affiliation: Department of Radiation Oncology.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okamoto
authors.affiliation: Department of Radiation Oncology.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shima
authors.affiliation: Department of Radiation Oncology.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tsuchida
authors.affiliation: Department of Radiation Oncology.
authors.forename: Tairo
authors.initials: T
authors.lastname: Kashihara
authors.affiliation: Department of Radiation Oncology.
authors.forename: Ken
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Radiation Oncology.
authors.forename: Kana
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Radiation Oncology.
authors.forename: Rei
authors.initials: R
authors.lastname: Umezawa
authors.affiliation: Department of Radiation Oncology.
authors.forename: Koji
authors.initials: K
authors.lastname: Inaba
authors.affiliation: Department of Radiation Oncology.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Radiation Oncology.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Igaki
authors.affiliation: Department of Radiation Oncology.
authors.forename: Jun
authors.initials: J
authors.lastname: Itami
keywords: cervical cancer; interstitial brachytherapy; primary radiotherapy