3D conformal HDR-brachy- and external beam therapy plus simultaneous Cisplatin for high-risk cervical cancer: Clinical experience with 3 year follow-up
| Autor: | Christian Kirisits, Gerhard Sissolak, Barbara Bachtiary, Tomas-Hendrik Knocke-Abulesz, Richard Pötter, Beata Klos, A. Rheinthaller, Johannes Dimopoulos |
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| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Deep vein Brachytherapy Uterine Cervical Neoplasms Antineoplastic Agents medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Progression-free survival Aged Neoplasm Staging Retrospective Studies Aged 80 and over Cervical cancer Chemotherapy business.industry Radiotherapy Planning Computer-Assisted Hematology Middle Aged medicine.disease Survival Analysis Thrombosis Neoadjuvant Therapy Surgery Pulmonary embolism Radiation therapy Treatment Outcome medicine.anatomical_structure Oncology Feasibility Studies Female Radiology Cisplatin Radiotherapy Conformal business Follow-Up Studies |
| Zdroj: | Radiotherapy and Oncology. 79:80-86 |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2006.01.007 |
| Popis: | 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 anaemia, 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 haematological toxicity is increased. Gastrointestinal morbidity is minimal when prospectively applying 3D dose volume constraints and MRI–based 3D dose volume adaptation. |
| Databáze: | OpenAIRE |
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