Differences in outcome for cervical cancer patients treated with or without brachytherapy

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Karlsson, JohannesDepartment of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden (author)

Differences in outcome for cervical cancer patients treated with or without brachytherapy

Article/chapterEnglish2017

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Philadelphia, USA :Elsevier,2017
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LIBRIS-ID:oai:DiVA.org:oru-53486
https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-53486URI
https://doi.org/10.1016/j.brachy.2016.09.011DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Purpose: To compare the clinical outcome of cervical cancer patients treated with primary radiotherapy with and without the addition of brachytherapy.Methods and Materials: In all, 220 patients with cervical cancer stage I-IV treated between 1993 and 2009 were included. Three or five 6.0 Gy fractions of brachytherapy were given in addition to the external beam radiotherapy to 134 patients, whereas 86 patients received external beam radiotherapy alone (EBRTA). In the EBRTA group, the patients received external boost instead of brachytherapy with a total dose to the tumor of 64-72 Gy.Results: The 5-year overall survival and cancer-specific survival rates of the complete series were 42.5% and 55.5%, respectively. The rates of primary complete remission, 5-year cancer-specific survival, and recurrence were 92.5%, 68.5%, and 31.3% for the brachytherapy group vs. 73.3%, 35.4%, and 37.2% for the EBRTA group. The survival (all types) of the patients receiving brachytherapy was significantly (p < 0.0001) better than for the patients treated with external boost, but the difference was most pronounced in FIGO stage II tumors. Higher FIGO stage, nonsquamous cell carcinoma histology, treatment with EBRTA, and lower total equal 2-Gy (EQD2) external dose were significantly associated with poorer survival, lower rate of remission, and higher recurrence rate in multivariate models.Conclusions: Primary tumor remission rate, recurrence rate, and all types of survival rates were improved in the brachytherapy group. Brachytherapy is important to achieve sufficient doses to the periphery and central part of the tumor and should always be considered in treatment of cervical carcinomas.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Radiologi och bildbehandling hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Radiology, Nuclear Medicine and Medical Imaging hsv//eng
Cervical cancer
radiotherapy
external beam radiotherapy
brachytherapy
prognosis

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Dreifaldt, Ann-Charlotte,1958-Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)ledt (author)
Bohr Mordhorst, Louise,1958-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Oncology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden(Swepub:oru)lbt (author)
Sorbe, Bengt,1947-Örebro universitet,Institutionen för hälsovetenskaper,Department of Oncology, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden(Swepub:oru)bse (author)
Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, SwedenInstitutionen för medicinska vetenskaper (creator_code:org_t)

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In:BrachytherapyPhiladelphia, USA : Elsevier16:1, s. 133-1401538-47211873-1449

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