Clinical Impact of Escalating Relative High-dose-rate Intracavitary Brachytherapy Dose in Stage IIB Cervical Cancer

Abstract

BACKGROUND/AIM: To investigate whether high-dose-rate (HDR) intracavitary brachytherapy (IBT) dose ratios can predict treatment outcomes in patients with stage IIB cervical cancer. PATIENTS AND METHODS: Ninety-three patients treated with weekly cisplatin-based concurrent chemoradiotherapy and HDR IBT were analyzed. Potential prognostic factors and treatment outcomes were compared between low-HDR-IBT-ratio (</=0.43) and high-HDR-IBT-ratio (>0.43) groups, and univariate and multivariate analyses were performed. RESULTS: Five-year disease-specific survival (DSS) and progression-free survival (PFS) rates were significantly shorter in the low-compared to the high-HDR-IBT-ratio group. A high HDR IBT ratio was confirmed as an independent prognostic factor for DSS and PFS. CONCLUSION: A high HDR IBT dose ratio improves DSS and PFS in patients with stage IIB cervical cancer. Therefore, active administration of HDR IBT beyond previously accepted levels may be necessary for the treatment of locally advanced cervical cancer.