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Title: Outcome of 6 fractions of 5.3 Gray HDR brachytherapy in combination with external beam radiotherapy for treatment of cervical cancer
Authors: Koh, W.Y. 
Lim, K. 
Tey, J. 
Lee, K.M.
Lim, G.H.
Choo, B.A. 
Keywords: Brachytherapy
Cervical cancer
Long fractionation
Issue Date: Oct-2013
Citation: Koh, W.Y., Lim, K., Tey, J., Lee, K.M., Lim, G.H., Choo, B.A. (2013-10). Outcome of 6 fractions of 5.3 Gray HDR brachytherapy in combination with external beam radiotherapy for treatment of cervical cancer. Gynecologic Oncology 131 (1) : 93-98. ScholarBank@NUS Repository.
Abstract: Objective. To review the characteristics, outcomes and toxicities of cervical cancer patients treated with 6 fractions of brachytherapy after external beam radiotherapy (EBRT). Methods. All patients diagnosed with cervical cancer from 2000 to 2009 who were referred for radical treatment and who received 6 fractions of brachytherapy were retrospectively reviewed. Overall survival (OS), disease free survival (DFS), local control (LC), distant control (DC) rate, acute and late toxicitieswere the primary endpoints. Results. Thirty-two patients with mainly advanced stage squamous cell carcinoma were identified and reviewed. Patients received EBRT of 45 to 50.4 Gy in 1.8 Gy daily fractions followed by 6 sessions of 3 channel brachytherapy of 5.3 Gy prescribed to point H. Response rates to treatment were good, with no residual disease in 84% six weeks after the completion of treatment.With a median follow up time of 8.1 years, the five-year OS, DFS, LC and distant control rates were 75%, 68.5%, 92.8% and 76.9% respectively. None of the patients developed any G3-4 acute toxicity but one patient who had advanced disease developed G3-4 proctitis with a fistula formation. Conclusions. HDR brachytherapy utilizing 6 fractions of 5.3 Gy prescribed to point H with concurrent chemoradiation is superior in terms of OS and LC to regimens that deliver a lower EQD2 dose to point A/H and is associated with very low rates of toxicities. © 2013 Elsevier Inc. All rights reserved.
Source Title: Gynecologic Oncology
ISSN: 00908258
DOI: 10.1016/j.ygyno.2013.07.102
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