Professional Documents
Culture Documents
Pi Is 0360301611018256
Pi Is 0360301611018256
2538 The Treatment Outcome Of Cervix Cancer Treated With External Beam Radiotherapy, High-dose-rate
Brachytherapy And Concurrent Chemotherapy
J. Lee1, K. Lee1, R. Lee1, H. Suh1, M. Kim1, S. C. Kim2, H. Moon2, W. Ju2
1
Dept. of Radiation Oncology, Ewha Women’s University, School of Medicine, Seoul, Korea, Republic of Korea, 2Dept. of
Obstetrics and Gynecology, Ewha Women’s University, School of Medicine, Seoul, Korea, Republic of Korea
Purpose/Objective(s): To analyze the treatment outcome of cervix cancer treated with definitive concurrent radiochemotherapy
and to evaluate the appropriacy of HDR brachytherapy fractionation of our institute.
Materials/Methods: 64 patients with cervix cancer stage IB1-IIIB who were treated between 2001 and 2009 at our institute were
included in this analysis. External beam radiotherapy was delivered to whole pelvis with dose of 41.4 - 50.4 Gy followed by mid-
line block delivering total dose up to 50.4 - 59.4 Gy in 28 - 33 fractions. In patients with para-aortic nodal involvement, extended
filed was used receiving 45 - 50.4 Gy. High-dose-rate intracavitary brachytherapy was performed twice a week with 192-Ir. The
prescription dose was 24 - 32 Gy in 6 - 8 fractions to point A. In all patients, platinum-based chemotherapy was administered
during the radiation therapy period except a day of brachytherapy.
Results: Seven patients had stage I disease (10.9%), 47 patients stage II (73.5%) and 10 patients stage III (15.6%). Median follow
up was 40 months (range, 6.5 - 119.2 months). The actual delivered dose to point A was median 74 GyEQD2 with a/b ratio of 10
(range, 64 to 80 GyEQD2). Persistent disease was found in 1 patient and 3-year local control rate was 94.1%. 3-year rate of pelvic
control and disease-free survival were 86.5% and 82.9%, respectively. Late rectal and urinary toxicities of Grade 2 were devel-
oped in 7 patients (10.9%) and 8 patients (12.5%), respectively. Only one patient experienced Grade 4 rectal toxicity and there was
no Grade 3 - 4 late urinary toxicity.
Conclusions: We achieved good local and pelvic control comparable to historical data with a median radiation dose of 74 GyEQD2 to
point A which is lower than the generally recommended dose of 85 - 90 GyEQD2. To confirm this result, longer follow up is needed.
Author Disclosure: J. Lee: None. K. Lee: None. R. Lee: None. H. Suh: None. M. Kim: None. S.C. Kim: None. H. Moon: None. W.
Ju: None.
2540 Clinical Results Of External Radiotherapy Alone With 3DCRT For Cervical Cancer: Can We Provide
Better Local Control Without Combination Treatment Including Intracavitary Brachytherapy?