The preliminary results of High-Dose-Rate intracavitary brachytherapy with small-sized cobalt-60 radioisotope in carcinoma of cervix uteri : The fi rst results of Thailand from Lampang regional cancer center
คำสำคัญ:
การฉายรังสีจากภายนอก, การสอดใส่แร่, อัตราการแผ่ปริมาณรังสีสูง, สารกัมมันตรังสีโคบอลต์ 60, มะเร็งปากมดลูก, ภาวะแทรกซ้อนบทคัดย่อ
Objective : to evaluate the treatment outcomes and gastrointestinal and genitourinary toxicity associated with Co-60 source in the high-dose-rate brachytherapy of cervical cancer. Study design: Retrospective, descriptive study Material and method : The data were retrospectivelly collected from medical records of women with stage I-III cervical cancer who recieved whole pelvic external beam radiotherapy followed by Co-60 source high-dose rate (HDR) brachytherapy from 1 December 2007 to 31 July 2010 at Lampang Cancer Center and were analyzed by using descriptive statistics. Toxicities were scored using Common Terminology Criteria of Adverse Events (CTCAE) version 3.0. Results : During the study period, 46 patients with cervical cancer were mean age 59.5 years. Twenty four patients (52.2%) were FIGO stage IIB, 14 patients (30.4%) were FIGO stage IIIB. They received 50 Gy in 25 fractions of pelvic external beam radiotherapy and 26.0 Gy in 4 fractions of HDR brachytherapy with Co-60 source. The median total treatment time was 56 days. The mean total BED (Gy10) for point A was 90.9 Gy (75.8-107.5), for rectum (BED Gy3) was 111.15 Gy (78.60-210.70) while that for bladder (BED Gy3) was 101.80 (76.80-171.80). Fourty patients (95.6%) were classifi ed complete response. The most common acute gastrointestinal toxicity was diarrhea (11 patients, 23.9%). One patient (2.2%) had grade 3 gastrointestinal toxicity while all others (10 patients, 21.7%) had ≤grade 2 toxicity. The most common acute genitourinary toxicity was urinary frequency (9 patients, 19.5%). All of them had ≤grade 2 toxicity. Six patients (13.0%) had late gastrointestinal toxicity (proctitis). One patient (2.2%) had grade 3 proctitis while others had only grade 1. Conclusion : The results of this study have shown that pelvic external beam radiotherapy followed by HDR brachytherapy with Co-60 source is effective, with acceptable toxicities and might be comparable with other radioisotope. Further long-term follow-up or study should be performed
เอกสารอ้างอิง
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Lampang Cancer Center. Cancer incidence in Northern Thailand 2003-2007, Hospital Cancer Registry 2009, Ministry of Public Health,Thailand 2009.
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