High Dose Rate Brachytherapy in the treatment of Uterine Cervical Cancer: Incidence of Late Radiation proctitis and cystitis among different schedules
Abstract
Purpose: This retrospective study at Mahavachiralongkorn hospital aims to explore the survival rate and incidence of radiation proctitis as well as cystitis in patients with uterine cervical cancer treated by high dose rate (HDR) intracavitary brachytherapy (ICRT) and also to compare the late complications among patients receiving different HDR schedules. Methods and materials: A hundred and sixty-eight patients with uterine cervical cancer stage IB-IIIB treated by external beam radiotherapy (EBRT) with a median dose of 5000 cGy followed by Iridium 192 HDR brachytherapy, 500 cGy/F x 5 fractions (57 cases), 600 cGy/F x 4 fractions (59 cases) and 700 cGy/F x 3fractions (52 cases) were enrolled in the study from January 2005 to June 2008. Most patients were assessed by physical examination during the follow-up period. Results: Median age of the patients in this study was 53 years (range of 28-87 years) and median follow-up time was 63 months. Five-year overall survival was 69.0% (95% confidential interval of 64.4%-73.7%). There was no significant difference in survival among the three HDR schedules (500 cGy/F x 5F, 600cGy/F x 4F and 700cGy/F x 3F), 67.0%, 68.0% and 65.0% respectively. The overall late radiation proctitis and cystitis rates were 17.8% and 2.3%, respectively. The incidence of late radiation procitis in 500 cGy/F x5F group was 12.3% which is lower than those in the other two groups, 600 cGy/Fx4F (20.3%)and 700 cGy/Fx3F (21.1%). Majority of the patients with late radiation proctitis presented with grade 1-2, and majority of late radiation cystitis presentation was grade1. There was no severe complication among these patients. Conclusions: In this study, there was no significant difference of 5- years overall survival and incidence of late radiation proctitis and cystitis among three HDR schedules.
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บุษณี วิบุลผลประเสริฐ, วรนุช ตั้งเจริญเสถียร. ภาวะแทรกซ้อนของรังสีรักษาในมะเร็งปากมดลูก. รายงานประกอบการศึกษาและฝึกอบรมตามหลักสูตร เพื่อวุฒิบัตรสาขารังสีวิทยาทั่วไป พ.ศ.2527: 1-25
สุพัตรา แสงรุจิ, วิสุทธิ์ วุฒิพฤกษ์, สายสงวน อุณหนันท์. ผลการรักษามะเร็งปากมดลูกชนิด Squamous cell carcinoma ระยะที่ 2 และ ระยะที่ 3 ด้วยเครื่อง Telecobalt และ Selectron LDR ที่โรงพยาบาลศิริราช ระหว่างปี พ.ศ. 2524-2529, วารสารโรคมะเร็ง 2532; 4: 123-9.
Tharavichitkul E, Klunkin P, Lorvidhaya V, Sukthomya V, Chakrabhandu S, Pukanhaphan N, et al. The effect of two HDR brachytherapy schedules in locally advanced cervical cancer treated with concurrent chemoradiation : a study from Chiang Mai, Thailand. J Radiat Res. 2012; 53(2):281-7
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