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J Korean Soc Ther Radiol Oncol > Volume 26(1); 2008 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2008;26(1): 24-34. doi: https://doi.org/10.3857/jkstro.2008.26.1.24
Accelerated Hyperfractionated Radiotherapy for Locally Advanced Uterine Cervix Cancers
Young Seok Seo, Chul Koo Cho, Seong Yul Yoo, Mi Sook Kim, Kang Mo Yang, Hyung Jun Yoo, Chul Won Choi, Kyung Hee Lee, Eui Don Lee, Sang Young Rhu, Suck Chul Choi, Moon Hong Kim, Beob Jong Kim
1Department of Radiation Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea. chcho@kcch.re.kr
2Department of Gynecologic Oncology, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.
To assess the efficacy of the use of accelerated hyperfractionated radiotherapy (AHRT) for locally advanced uterine cervix cancers.
Between May 2000 and September 2002, 179 patients were identified with FIGO stage IIB, IIIB, and IVA cancers. Of the 179 patients, 45 patients were treated with AHRT (AHRT group) and 134 patients were treated with conventional radiotherapy (CRT group), respectively. Patients undergoing the AHRT regimen received a dose of 30 Gy in 20 fractions (1.5 Gyx2 fractions/day) to the whole pelvis. Subsequently, with a midline block, we administered a parametrial boost with a dose of 20 Gy using 2 Gy fractions. Patients also received two courses of low-dose-rate brachytherapy, up to a total dose of 85~90 Gy to point A. In the CRT group of patients, the total dose to point A was 85~90 Gy. The overall treatment duration was a median of 37 and 66 days for patients that received AHRT and CRT, respectively. Statistical analysis was calculated by use of the Kaplan-Meier method, the log-rank test, and Chi-squared test.
For patients that received cisplatin-based concurrent chemotherapy and radiotherapy, the local control rate at 5 years was 100% and 79.2% for the AHRT and CRT group of patients, respectively (p=0.028). The 5-year survival rate for patients with a stage IIB bulky tumor was 82.6% and 62.1% for the AHRT group and CRT group, respectively (p=0.040). There was no statistically significant difference for severe late toxicity between the two groups (p=0.561).
In this study, we observed that treatment with AHRT with concurrent chemotherapy allows a significant advantage of local control and survival for locally advanced uterine cervix cancers.
Key Words: Uterine cervix carcinoma, Hyperfractionation, Acceleration, Radiotherapy, Concurrent chemoradiotherapy
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