3D conformal HDR-brachy- and external beam therapy plus simultaneous Cisplatin for high-risk cervical cancer:: Clinical experience with 3 year follow-up

被引:52
作者
Poetter, Richard
Dimopoulos, Johannes
Bachtiary, Barbara
Sissolak, Gerhard
Klos, Beata
Rheinthaller, A.
Kirisits, C.
Knocke-Abulesz, Tomas-Hendrik
机构
[1] Univ Vienna, Dept Radiotherapy & Radiobiol, A-1090 Vienna, Austria
[2] Univ Vienna, Dept Internal Med 1, Div Clin Oncol, A-1090 Vienna, Austria
[3] Univ Vienna, Dept Obstet & Gynecol, A-1090 Vienna, Austria
[4] Lainz Hosp, Dept Radiotherapy, A-1130 Vienna, Austria
关键词
radiochemotherapy; cisplatin; cervical cancer; 3D HDR-brachytherapy;
D O I
10.1016/j.radonc.2006.01.007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and purpose: To assess feasibility, safety and effectiveness of CT-based 3D conformal external beam radiotherapy (EBRT) plus concurrent cisplatin and MRI-based 3D conformal HDR-brachytherapy (HDR-BT) in the treatment of advanced cervical cancer. Patients and methods: A total of 48 patients with advanced cervical cancer, treated with CT-based EBRT plus simultaneous cisplatin chemotherapy (40mg/m(2) of body surface per week for 5 weeks) and MRI-based HDR-BT, were included for analysis. Results: All patients completed radiotherapy as planned and 90% received at least four cycles chemotherapy. Frequencies of CTC grade 3 anaernia, grade 3-4 leucopenia and grade 3 thrombocytopenia were 4, 23 and 10%, respectively. Two patients developed deep vein thrombosis and one non-fatal pulmonary embolism. Grade 4 genitourinary late side effects (bladder) occurred in 2 patients. No grade 3-4 gastrointestinal side effects were observed. Complete response (CR) was obtained in 45 patients (94%). After a median follow-up of 33 months, 27 patients were disease free. Actuarial overall survival at 3 years was 61%, progression free survival 51% and continuous complete remission for true pelvis 85%. Conclusions: MRI-based 3D HDR-BT and 3D EBRT plus cisplatin appears to be safe and effective, although acute haematotogical toxicity is increased. Gastrointestinal morbidity is minimal when prospectively applying 3D dose volume constraints and MRI-based 3D dose volume adaptation. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:80 / 86
页数:7
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