Journal ArticleDOI
Phase III randomized trial comparing LDR and HDR brachytherapy in treatment of cervical carcinoma.
Prasert Lertsanguansinchai,Chawalit Lertbutsayanukul,Kanjana Shotelersuk,Chonlakiet Khorprasert,Prayuth Rojpornpradit,Taywin Chottetanaprasith,Apiradee Srisuthep,Sivalee Suriyapee,Chotika Jumpangern,Damrong Tresukosol,Chulee Charoonsantikul +10 more
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Comparable outcomes were demonstrated between LDR and HDR intracavitary brachytherapy, and the high number of distant failure suggests that other modalities such as systemic concurrent or adjuvant chemotherapy might lower this high recurrence, especially in Stage IIB and IIIB patients.Abstract:
Purpose Intracavitary brachytherapy plays an important role in the treatment of cervical carcinoma. Previous results have shown controversy between the effect of dose rate on tumor control and the occurrence of complications. We performed a prospective randomized clinical trial to compare the clinical outcomes between low-dose-rate (LDR) and high-dose-rate (HDR) intracavitary brachytherapy for treatment of invasive uterine cervical carcinoma. Methods and materials A total of 237 patients with previously untreated invasive carcinoma of the uterine cervix treated at King Chulalongkorn Memorial Hospital were randomized between June 1995 and December 2001. Excluding ineligible, incomplete treatment, and incomplete data patients, 109 and 112 patients were in the LDR and HDR groups, respectively. All patients were treated with external beam radiotherapy and LDR or HDR intracavitary brachytherapy using the Chulalongkorn treatment schedule. Results The median follow-up for the LDR and HDR groups was 40.2 and 37.2 months, respectively. The actuarial 3-year overall and relapse-free survival rate for all patients was 69.6% and 70%, respectively. The 3-year overall survival rate in the LDR and HDR groups was 70.9% and 68.4% ( p = 0.75) and the 3-year pelvic control rate was 89.1% and 86.4% ( p = 0.51), respectively. The 3-year relapse-free survival rate in both groups was 69.9% ( p = 0.35). Most recurrences were distant metastases, especially in Stage IIB and IIIB patients. Grade 3 and 4 complications were found in 2.8% and 7.1% of the LDR and HDR groups ( p = 0.23). Conclusion Comparable outcomes were demonstrated between LDR and HDR intracavitary brachytherapy. Concerning patient convenience, the lower number of medical personel needed, and decreased radiation to health care workers, HDR intracavitary brachytherapy is an alternative to conventional LDR brachytherapy. The high number of distant failure suggests that other modalities such as systemic concurrent or adjuvant chemotherapy might lower this high recurrence, especially in Stage IIB and IIIB.read more
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Journal ArticleDOI
American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part II: high-dose-rate brachytherapy.
Akila N. Viswanathan,Sushil Beriwal,Jennifer F. De Los Santos,D. Jeffrey Demanes,David K. Gaffney,Jorgen L. Hansen,Ellen L. Jones,Christian Kirisits,Bruce R. Thomadsen,Beth Erickson +9 more
TL;DR: These guidelines update those of 2000 and provide a comprehensive description of HDR cervical cancer brachytherapy in 2011 and affirms the essential curative role of tandem-based brachyTherapy in the management of locally advanced cervical cancer.
Journal ArticleDOI
Advances in Radiotherapy and Implications for the Next Century: A Historical Perspective
Philip P. Connell,Samuel Hellman +1 more
TL;DR: The use of ionizing radiation for the treatment of cancer dates back to the late 19th century, remarkably soon after Roentgen described X-rays in 1895 and the use of brachytherapy after Marie and Pierre Curie discovered radium in 1898.
Journal ArticleDOI
British HIV Association guidelines for HIV-associated malignancies 2014
Mark Bower,Simon Collins,C Cottrill,Kate Cwynarski,Silvia Montoto,Mark T. Nelson,Nneka Nwokolo,Thomas Powles,Justin Stebbing,N Wales,Andrew Webb +10 more
TL;DR: The aim of this monograph is to provide a chronology of key events and milestones in the development of HIV/AIDS-related cancers over a 12-month period from 1989 to 2002, and to promote awareness of the importance of timely diagnosis and ART.
Journal ArticleDOI
High dose rate versus low dose rate intracavity brachytherapy for locally advanced uterine cervix cancer.
TL;DR: A meta-analysis of randomised controlled trials that compared HDR with LDR ICBT, combined with EBRT, for women with locally advanced uterine cervical cancer indicated that there were no significant differences except for increased small bowel complications with HDRs.
Journal ArticleDOI
Five years' experience treating locally advanced cervical cancer with concurrent chemoradiotherapy and high-dose-rate brachytherapy: results from a single institution.
TL;DR: The results of the study have shown that the regimen is effective, with acceptable long-term side effects, and the most important prognostic factor was the pretreatment hemoglobin level, a disease-related factor.
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