DOI QR코드

DOI QR Code

High Dose Rate Cobalt-60 After Loading Intracavitary Therapy of the Uterine Cervical Carcinoma in Srinagarind Hospital, Analysis of Residual Disease

  • Pesee, Montien (Division of Radiotherapy, Department of Radiology, Faculty of Medicine, Khon Kaen University) ;
  • Krusun, Srichai (Division of Radiotherapy, Department of Radiology, Faculty of Medicine, Khon Kaen University) ;
  • Padoongcharoen, Prawat (Division of Radiotherapy, Department of Radiology, Faculty of Medicine, Khon Kaen University)
  • Published : 2012.09.30

Abstract

Objectives: To evaluate residual disease in uterine cervical cancer patients treated with teletherapy using combined high dose rate Cobalt-60 brachytherapy. Materials and Methods: A retrospective study of uterine cervical cancer patients, FIGO stages IB-IVB (International Federation of Gynecologists and Obstetricians recommendations), treated by radiotherapy alone between April 1986 and December 1988 was conducted and the outcomes analysed. The patients were treated using teletherapy 50 Gy/25 fractions, five fractions per week to the whole pelvis together with HDR Cobalt -60 afterloading brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions. Results: The study covered 141 patients with uterine cervical cancer. The mean age was 50.0 years with a range of 30-78 years. The mean tumor size was 4.1 cm in diameter (range 1-8 cm). Mean follow - up time was 2.94 years (range 1 month-6.92 years). The overall incidence of residual locoregional disease was 3.5%. Residual disease, according to stage IIB, IIIB and IVA was present in 2.78%, 3.37% and 50.0%. It was noted that there was no evidence of residual disease in stage IB and IIA cases. Conclusion: Combined teletherapy along with high dose rate Cobalt -60 brachytherapy of 850 cGy/fraction, weekly to point A for 2 fractions resulted in overall 3.5% residual disease and a 96.5% complete response. The proposed recommendation for improving outcome is initiation of measurements for early detection of disease.

Keywords

References

  1. Bermudez RS, Huang K, Hsu IC (2010). Cervical cancer. In: handbook of evidence- based radiation oncology, second edition. Hansen EK, Roach III M, eds. New York: Spinger, 499-512.
  2. Franckena M, Lutgens LC, Koper PC, et al (2009). Radiotherapy and hyperthermia for treatment of primary locally advanced cervix cancer: results in 378 patients. Int J Radiation Oncology Biol Phys, 73, 242-50. https://doi.org/10.1016/j.ijrobp.2008.03.072
  3. Hassele MD, Rose BS, Kochanski JD, et al (2011). Clinical outcomes of intensity-modulated pelvic radiation therapy for carcinoma of the cervix. Int J Radiation Oncology Biol Phys, 80, 1436-45. https://doi.org/10.1016/j.ijrobp.2010.04.041
  4. International Federation of Gynecologists and Obstetricians (1995). Staging announcement: FIGO staging of gynecologic cancers: cervical and vulva. Int J Gynecol Cancer, 5, 319.
  5. Mabuchi S, Ugaki H, Isohashi F, et al (2010). Concurrent Nedaplatin, external beam radiotherapy and high-dose-rate brachytherapy in patients with FIGO stage IIIB cervical cancer: A comparison with a cohort treated by radiotherapy alone. Gynecol Obstet Invest, 69, 224-32. https://doi.org/10.1159/000273207
  6. Matsuura K, Tanimoto H, Fujita K, et al (2007). Early clinical outcomes of 3D- conformal radiotherapy using accelerated hyperfractionation without intracavitary brachytherapy for cervical cancer. Gynecologic Oncology, 104, 11-4. https://doi.org/10.1016/j.ygyno.2006.06.033
  7. Perez CA (1997). Uterine cervix. In: Textbook of principles and practice of radiation oncology, third edition. Perez CA, Brady LW, eds.New York, Lippincott-Raven Pub, 1806-8.
  8. Perez CA, Grigsby PW, Chao KS, et al (1998). Tumor size, irradiation dose, and long-term outcome of carcinoma of the uterine cervix. Int J Radiat Oncol Biol Phys, 41, 307-17. https://doi.org/10.1016/S0360-3016(98)00067-4
  9. Pesee M,Tangvoraphonkchai V, Reamsiri T, et al (1995).Low dose rate brachytherapy Caesium -137 afterloading in the treatment of carcinoma of uterine cervix in Srinagarind hospital:Analysis of a actuarial survival rate. Thai J Radiol, 1, 125-30.
  10. Pesee M, Krusun S, Padoongcharoen P (2010). High dose rate Cobalt-60 afterloading intracavitary therapy of the uterine cervical carcinoma in Srinagarind hospital, analysis of complications. Asian Pac J Cancer Prev, 11, 491-4.
  11. Pesee M, Krusun S, Padoongcharoen P (2010). High dose rate Cobalt-60 afterloading intracavitary therapy of the uterine cervical carcinoma in Srinagarind hospital, Analysis of survival. Asian Pac J Cancer Prev, 11, 1469-71.
  12. Sundfor K, Trope CG, Hogberg T, et al (1996). Radiotherapy and neoadjuvant chemotherapy for cervical cancer. A randomized multicenter study of sequential cisplatin and 5-fluorouracil and radiotherapy in advanced cervical carcinoma stage IIIB and IVA. Cancer, 77, 2371-8. https://doi.org/10.1002/(SICI)1097-0142(19960601)77:11<2371::AID-CNCR28>3.0.CO;2-T
  13. Sriamporn S, Swaminathan R, Parkin DM, et al (2004). Lossadjusted surivival of cervix cancer in Khon Kaen, Northeast Thailand. Bri J Cancer, 91, 106-10. https://doi.org/10.1038/sj.bjc.6601959
  14. Symonds RP (2003). Cancer of the cervix and vagina. In: Text book of evidence- based oncology.Williams C, ed. London: BMJ, 402-9.
  15. Visser AG, Symonds RP (2001). Dose and volume specification for reporting gynaecological brachytherapy: time for a change. Radiother Oncol, 58, 1-4. https://doi.org/10.1016/S0167-8140(00)00323-6
  16. Veldeman L,Madani I, Hulstaert F, et al (2008). Evidence behind use of intensity-modulated radiotherapy: a systematic review of comparative clinical studies. Lancet Oncol, 9, 367-75. https://doi.org/10.1016/S1470-2045(08)70098-6

Cited by

  1. Comparisons between the KKU-Model and Conventional Rectal Tubes as Markers for Checking Rectal Doses during Intracavitary Brachytherapy of Cervical Cancer vol.15, pp.15, 2014, https://doi.org/10.7314/APJCP.2014.15.15.6115
  2. Vaginal Dose, Toxicity and Sexual Outcomes in Patients of Cervical Cancer Undergoing Image Based Brachytherapy vol.15, pp.8, 2014, https://doi.org/10.7314/APJCP.2014.15.8.3619