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| The observation of 160 cases of cervical carcinoma with 192Ir afterloading intracavitary brachytherapy and external beam intensity-modulated radiation therapy |
| ZHANG Wen, SHI Linxin, YUAN Cheng, LIU Yazhou, SUN Suping, MIAO Hui |
| Department of Radiation Oncology, Xuzhou Cancer Hospital, Xuzhou 221000 China |
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Abstract Objective To study the efficacy and radiation response of 192Ir high dose rate intracavitary radiotherapy combined with in vitro contrast-enhanced radiotherapy (IMRT) in the treatment of cervical cancer. Methods From January 2011 to December 2016, 160 stage Ⅰ-Ⅳ cervical cancer patients confirmed pathologically were treated with combination of HDR 192Ir after loading intracavitary brachytherapy plus external beam IMRT. A midplane dose of 45-50 Gy IMRT at 1.8-2.0 Gy per fraction to the whole pelvis were given five times a week. Intracavitary brachytherapy was delivered to a total dose of 21-24 Gy at 5-8 Gy per fraction, once a week. Results The 1-and 3-year survival rates were 100% and78.75%. The 3-year survival rate was significantly different from that of stage I and Ⅱ, Ⅲ and IV (100%、80%, 63.89%、16.67%, P<0.05). There was no significant difference between that of stage Ⅱ and Ⅲ (80%、63.89%, P>0.05). There was significant difference from that of pathological stage I and Ⅱ of stage Ⅱ and Ⅲ cervical cancer patients (100%、53.33%, 100%、33.33%, P<0.05). There was no significant difference in the survival rate of patients with pathological stage IV (P>0.05). In patients with stage Ⅱ and Ⅲ, the 3-year survival rate has a significant difference between tumor diameter <4 cm and >4 cm (P<0.05). However, there was no significant difference between tumor diameter <4 cm and >4 cm in stage IV patients. Immediate ractal reaction and late radioproctitis were present in 21.8% and 7%, acute and chronic radiation cystitis in 7.5% and 5%, respectivity. Rectovaginal fistula developed in 0.625%. Conclusion HDR after loading Intracavitary brachytherapy combined with external IMRT is effective and less toxic in the treatment of carcinoma of uterine cervix.
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Received: 13 February 2018
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