An early report on outcomes from computed tomographic-based high-dose-rate brachytherapy for locally advanced cervix cancer: A single institution experience

Abhirami Hallock; Kathleen Surry; Deidre Batchelar; Lauren Vanderspek; Jasper Yuen; Alex Hammond; John Radwan; Brian Yaremko; George Rodrigues; David D'Souza

doi:10.1016/j.prro.2011.01.004

An early report on outcomes from computed tomographic-based high-dose-rate brachytherapy for locally advanced cervix cancer: A single institution experience

Pract Radiat Oncol. 2011 Jul-Sep;1(3):173-81. doi: 10.1016/j.prro.2011.01.004. Epub 2011 May 14.

Authors

Affiliations

¹ Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada. Electronic address: ahallock@uwo.ca.
² Departments of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London, Ontario, Canada.
³ Odette Cancer Centre, Toronto, Ontario, Canada.
⁴ Odette Cancer Centre, Toronto, Ontario, Canada; Providence Saint Joseph Medical Center, Burbank, California.
⁵ Providence Saint Joseph Medical Center, Burbank, California.
⁶ Peel Regional Cancer Centre, Mississauga, Ontario, Canada.

PMID: 24673947
DOI: 10.1016/j.prro.2011.01.004

Abstract

Purpose: To report our experience using high-dose-rate (HDR) brachytherapy with computed tomographic (CT) imaging for locally advanced cervix cancer, using available resources to optimize the treatment.

Methods and materials: Fifty-seven women with cervix cancer were treated between September 2004 and March 2008. Patients received external radiotherapy, HDR brachytherapy (7 Gy x4) and concurrent chemotherapy. CT planning was done for each insertion.

Results: Median age was 53 years (range, 29-89 years); majority (49%) had International Federation of Gynecology and Obstetrics stage IIB. The median follow-up was 22.6 months. There were 4 patients who required laser coagulation for rectal bleeding, and one patient required hemicolectomy for sigmoid stricture. There was no grade 3 or 4 genitourinary toxicity. The Kaplan-Meier overall survival, relapse free, central pelvic and pelvic control at 3 years was 86%, 62%, 89%, and 83%, respectively. Pelvic control for tumors 2 to 5 cm was 95% and 84% for tumors greater than 5 cm.

Conclusions: Our early experience confirms that CT-based HDR brachytherapy for cervix cancer achieves disease control comparable to other published series. At the same time, conformal avoidance of organs at risk allows for low rates of toxicity.