Comparative study of LDR (Manchester System) and HDR Image-guided Conformal Brachytherapy of cervical cancer: Patterns of failure, late complications, and survival

Narayan, Kailash, van Dyk, Sylvia, Bernshaw, David, Rajasooriyar, Chrishanthi and Kondalsamy-Chennakesavan, Srinivas (2009) Comparative study of LDR (Manchester System) and HDR Image-guided Conformal Brachytherapy of cervical cancer: Patterns of failure, late complications, and survival. International Journal of Radiation: Oncology - Biology - Physics, 74 5: 1529-1535. doi:10.1016/j.ijrobp.2008.10.085


Author Narayan, Kailash
van Dyk, Sylvia
Bernshaw, David
Rajasooriyar, Chrishanthi
Kondalsamy-Chennakesavan, Srinivas
Title Comparative study of LDR (Manchester System) and HDR Image-guided Conformal Brachytherapy of cervical cancer: Patterns of failure, late complications, and survival
Journal name International Journal of Radiation: Oncology - Biology - Physics   Check publisher's open access policy
ISSN 0360-3016
Publication date 2009-08-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.ijrobp.2008.10.085
Open Access Status
Volume 74
Issue 5
Start page 1529
End page 1535
Total pages 7
Editor J. D. Cox
Place of publication United States
Publisher Elsevier Inc.
Language eng
Subject C1
920114 Reproductive System and Disorders
920102 Cancer and Related Disorders
111204 Cancer Therapy (excl. Chemotherapy and Radiation Therapy)
111402 Obstetrics and Gynaecology
Abstract Purpose: To compare patterns of failure, late toxicities, and survival in locally advanced cervical cancer patients treated by either low-dose-rate (LDR) or conformal high-dose-rate (HDRc) brachytherapy as a part of curative radiotherapy. Materials and Methods: A retrospective comparative study of 217 advanced cervix cancer patients was conducted; 90 of these patients received LDR and 127 received HDRc brachytherapy. All patients were staged using International Federation of Gynecology and Obstetrics (FIGO) rules, had pretreatment magnetic resonance imaging (MRI), and were treated with concurrent cisplatin chemoradiotherapy. Both groups matched for FIGO stage, MRI tumor volume, and uterine invasion status. Results: Local and pelvic failures were similar 12–13% and 14% both in both groups. Abdominal and systemic failures in LDR group were 21% and 24%, whereas corresponding failures in HDRc group were 20% and 24%. Sixty-eight percent (87/127) of patients treated by HDRc remained asymptomatic, whereas 42% (38/90) of patients were asymptomatic from the bowel and bladder symptoms after treatment with LDR. The 5-year OS rate was 60% (SE = 4%). The 5-year failure-free survival rate was 55% (SE = 3%). There was no significant difference between the groups. Conclusions: Image-guided HDRc planning led to a large decrease in late radiation effects in patients treated by HDRc. Patterns of failure and survival were similar in patients treated either by LDR or HDRc.
Formatted abstract
Purpose: To compare patterns of failure, late toxicities, and survival in locally advanced cervical cancer patients treated by either low-dose-rate (LDR) or conformal high-dose-rate (HDRc) brachytherapy as a part of curative radiotherapy.
Materials and Methods: A retrospective comparative study of 217 advanced cervix cancer patients was conducted; 90 of these patients received LDR and 127 received HDRc brachytherapy. All patients were staged using International Federation of Gynecology and Obstetrics (FIGO) rules, had pretreatment magnetic resonance imaging (MRI), and were treated with concurrent cisplatin chemoradiotherapy. Both groups matched for FIGO stage, MRI tumor volume, and uterine invasion status.
Results: Local and pelvic failures were similar 12–13% and 14% both in both groups. Abdominal and systemic failures in LDR group were 21% and 24%, whereas corresponding failures in HDRc group were 20% and 24%. Sixty-eight percent (87/127) of patients treated by HDRc remained asymptomatic, whereas 42% (38/90)
of patients were asymptomatic from the bowel and bladder symptoms after treatment with LDR. The 5-year OS rate was 60% (SE = 4%). The 5-year failure-free survival rate was 55% (SE = 3%). There was no significant difference between the groups.
Conclusions: Image-guided HDRc planning led to a large decrease in late radiation effects in patients treated by HDRc. Patterns of failure and survival were similar in patients treated either by LDR or HDRc.
Keyword Cervix
HIGH-DOSE-RATE
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 29 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 31 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Thu, 03 Sep 2009, 17:45:49 EST by Mr Andrew Martlew on behalf of Obstetrics & Gynaecology - RBWH