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Modified partial hyperfractionation in radiotherapy for bulky uterine cervical cancer: reduction of overall treatment time.

Authors
Chun, M  | Kang, S  | Ryu, H  | Chang, K  | Oh, Y  | Ju, H  | Lee, E
Citation
International journal of radiation oncology, biology, physics, 47(4). : 973-977, 2000
Journal Title
International journal of radiation oncology, biology, physics
ISSN
0360-30161879-355X
Abstract
PURPOSE: The purpose of this study was to assess the feasibility and toxicity of modified fractionation of external beam radiation with the intention of reducing the overall treatment time (OT) by 1 week in cervical cancer.



METHODS AND MATERIALS: Thirty-one patients (Group 1, n = 31) with bulky cervical cancer (>/= 4 cm with Stage II and III, >/= 5 cm with Stage IB2) were entered into the twice a day (b.i. d.) protocol (18 Gy/10 fx in 2 weeks followed by 18 Gy/12 fx, b.i.d. in 6 days, then midline block at 36 Gy with 45 Gy to the whole pelvis and 51-59 Gy to the parametrium). These patients underwent high-dose-rate brachytherapy with 4 Gy/fx x 7 to point A, biweekly. During the same period, patients with non-bulky tumors (Group 2, n = 31) received conventional treatment and similar brachytherapy.



RESULTS: The OT of Group 1 was 7 weeks or less in 61.3%, 7.1-8 weeks in 29%, and more than 8 weeks in 9.7% (19.4%, 51.6%, and 29% in Group 2, respectively, p = 0.003). Incidences of acute complications and treatment breaks were similar in both groups. Late complication (rectal bleeding) occurred only in Group 1 (13%, 4/31), but was self-limited. Locoregional failures occurred within 2 years after completion of radiation therapy in both groups (16% and 13% in Group 1 and 2, respectively, with minimum and median follow-ups of 2 years and 34 months).



CONCLUSION: Partial hyperfractionation on the third week of radiation permitted patients to finish their treatment with shorter OT without excessive acute complications and with acceptable grade 2 late rectal bleeding complications. This treatment scheme may be an effective method for the improvement of local control of bulky cervical cancer.
MeSH

PMID
10863067
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiation Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Obstetrics & Gynecology
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Humanities & Social Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Ajou Authors
강, 승희  |  오, 영택  |  유, 희석  |  이, 은주  |  장, 기홍  |  전, 미선  |  주, 희재
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