Treatment Method Shows Local Control of Cervical Cancer

Computed-tomography (CT)-planned high-dose-rate (HDR) intracavitary brachytherapy (BT) showed excellent local control for patients with stage 1 or 2 cervical cancer, according to a recent study. 
Excellent local control (LC) and survival was shown with the use of computed-tomography (CT)-planned high-dose-rate (HDR) intracavitary brachytherapy (BT) for patients with stage 1 or 2 cervical carcinoma, according to the findings of a recent study published in Gynecologic Oncology.

With a median follow-up of 30 months, no patients experienced local-only recurrence.

“We found that, of nine patient characteristics and various RT prognostic factors tested in a univariate analysis, tumor size and total external beam radiation therapy (EBRT) plus BT dose were initially the most significant prognostic factors for predicting any recurrence (AR),” Akila N. Viswanathan, M.D., executive vice chair, Johns Hopkins Radiation Oncology and Molecular Radiation Sciences, and her colleagues wrote in the study.

However, a bivariate model showed that total EBRT plus BT dose were no longer significant when adjusted for tumor size, the authors wrote. The authors of the study found large tumor size to be a prognostic factor for increased risk of recurrence outside the radiation field and worse progression-free survival (PFS) and overall survival (OS). Patients with tumors larger than 4 cm were three times more likely to develop regional or distant recurrence, compared with patients who had tumors smaller than 4 cm.

Moreover, the researchers also found that a volume-optimized plan treated a smaller area than a standard, Point A plan for these patients.

A total of 150 patients were treated for stage 1/2 cervical cancer using HDR CT-planned BT between April 2004 and October 2014 at Brigham and Women’s Hospital. One-hundred twenty-eight women met eligibility criteria for the current study, as they had stage 1/2 disease, were treated with CT-based BT, and were not treated with interstitial BT.

Patients were staged according to the International Federation of Gynecology and Obstetrics (FIGO) guidelines. Clinical examination reports provided information about tumor size, which was also subsequently confirmed using CT or MR. Small and large tumor size were defined as up to 4 cm and more than 4 cm, respectively.

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