Management of Stage I-B, II-A, and II-B Carcinoma of the Cervix with High-Dose-Rate Brachytherapy: Initial Results of an Institutional Clinical Trial

Andre A. Abitbol, Aaron H. Wolfson, Alan A. Lewin, Pavel V. Houdek, Karen A. Laufer, Alfred H. Brandon, Joseph Y. Ting, William A. Raub, Hervy E. Averette, Bernd U. Sevin, Arnold M. Markoe

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

In 1989, the University of Miami began a program incorporating high-dose-rate (HDR) brachytherapy into the definitive treatment of patients with invasive carcinoma of the cervix. Patients received an average total dose to point A of 5,511 cGy (range 4,280-6,360 cGy) in an average of 57 days (range 39-84 days). An analysis of the first 24 cases found 11 FIGO Stage I-B, four Stage II-A, and nine Stage II-B tumors. At the end of all radiation therapy, 19/24 patients' tumors (79.2%) had undergone a clinical complete response (CR). With median follow-up of 26 months (range 14-63 months), three have relapsed locally, two regionally, and six in extrapelvic sites. Almost two-thirds of all failures occurred in patients with tumors >4 cm, who also took more than 8 weeks to complete their treatment. Overall 2-year actuarial survival for the entire study group is approximately 74%. A univariate analysis determined that clinical stage (P = 0.02), overall treatment time (P = 0.03), tumor size (P = 0.05), and response at the end of therapy (P = 0.005) were significant prognostic factors. Multivariate analysis showed that tumor response to therapy was the most important prognosticator of outcome (P = 0.001). Besides five cases of apical vaginal stenosis, there have been no reported chronic complications in this cohort of patients. A prospectively randomized trial is recommended to compare the efficacy of HDR vs. low-dose-rate brachytherapy in cervical carcinoma.

Original languageEnglish (US)
Pages (from-to)223-228
Number of pages6
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume19
Issue number3
DOIs
StatePublished - Jun 1996

Keywords

  • Cervical carcinoma
  • High-dose-rate brachytherapy
  • Radiation therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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