Abstract
Purpose: Retrospective studies have suggested that overall treatment time is an important determinant of outcome for locally advanced squamous carcinoma of the cervix managed with definitive radiotherapy. We initiated a prospective clinical trial to test the hypothesis that minimizing treatment time can prevent tumor cell repopulation in squamous cell carcinoma of the cervix. Materials and Methods: Between 1989 and 1994 twenty two patients with FIGO stage IIIA to IVA squamous cell carcinoma of the cervix were treated as follows: Forty-five Gy was delivered to the whole pelvis in 25 fractions in 5 weeks using photon energies of 6 MV or greater. On Monday, Wednesday, and Friday of each of the last three weeks of treatment, a boost treatment of 1.6 Gy was given via small lateral parallel opposed fields, six hours after the first fraction. Thus, the total dose to the tumor and parametrial region was 59.4 Gy. A single brachytherapy procedure (Standard Tandem and Ovoids or Interstitial Template) was performed one week after the completion of external beam radiotherapy to bring the point A dose to 90 Gy in 6 weeks. Results: With a median follow-up of 30 months, (range: 5 to 42 months) the actuarial 3 year overall
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Citation Formats
Gieschen, H, Kavanagh, B, Kaufman, N, West, R, Goplerud, D, and Schmidt-Ullrich, R.
A pilot study of accelerated superfractionated radiotherapy for locally advanced cancer of the uterine cervix.
United States: N. p.,
1995.
Web.
doi:10.1016/0360-3016(95)97830-T.
Gieschen, H, Kavanagh, B, Kaufman, N, West, R, Goplerud, D, & Schmidt-Ullrich, R.
A pilot study of accelerated superfractionated radiotherapy for locally advanced cancer of the uterine cervix.
United States.
https://doi.org/10.1016/0360-3016(95)97830-T
Gieschen, H, Kavanagh, B, Kaufman, N, West, R, Goplerud, D, and Schmidt-Ullrich, R.
1995.
"A pilot study of accelerated superfractionated radiotherapy for locally advanced cancer of the uterine cervix."
United States.
https://doi.org/10.1016/0360-3016(95)97830-T.
@misc{etde_20420685,
title = {A pilot study of accelerated superfractionated radiotherapy for locally advanced cancer of the uterine cervix}
author = {Gieschen, H, Kavanagh, B, Kaufman, N, West, R, Goplerud, D, and Schmidt-Ullrich, R}
abstractNote = {Purpose: Retrospective studies have suggested that overall treatment time is an important determinant of outcome for locally advanced squamous carcinoma of the cervix managed with definitive radiotherapy. We initiated a prospective clinical trial to test the hypothesis that minimizing treatment time can prevent tumor cell repopulation in squamous cell carcinoma of the cervix. Materials and Methods: Between 1989 and 1994 twenty two patients with FIGO stage IIIA to IVA squamous cell carcinoma of the cervix were treated as follows: Forty-five Gy was delivered to the whole pelvis in 25 fractions in 5 weeks using photon energies of 6 MV or greater. On Monday, Wednesday, and Friday of each of the last three weeks of treatment, a boost treatment of 1.6 Gy was given via small lateral parallel opposed fields, six hours after the first fraction. Thus, the total dose to the tumor and parametrial region was 59.4 Gy. A single brachytherapy procedure (Standard Tandem and Ovoids or Interstitial Template) was performed one week after the completion of external beam radiotherapy to bring the point A dose to 90 Gy in 6 weeks. Results: With a median follow-up of 30 months, (range: 5 to 42 months) the actuarial 3 year overall survival is 61.5% and the disease-free survival is 51.4%. Two out of twenty two patients (9.1%) had loco-regional failure alone, (5(22)) (22.7%) had distant failure only, and (4(22)) (18.2%) had both. The actuarial loco-regional control at 3 years is 69.5% with a distant metastasis-free survival of 57.5%. The median length of treatment was 46 days with a range of 35 to 107 days Most of the patients had only mild acute reactions, mainly diarrhea. There were no severe acute reactions. Thirteen of 22 patients (59.1%) had no late complications. Three patients had chronic proctitis, one with intermittent bleeding. Six (27.3%) patients experienced severe late complications consisting of vesico-vaginal fistulas, recto-vaginal fistulas and small bowel obstruction. One patient experienced severe hip dysfunction. A detailed analysis of tumor burden, dose and treatment volume in patients with complications will be given. Conclusions: This new regimen delivers a high dose to point A over a short amount of time and decreases the time of hospitalization since only one brachytherapy procedure is performed. The overall survival, disease-free survival, local control and distant metastases rate are comparable to or better than results reported in the literature. However, a higher rate of late complications is observed with this regimen. Possible reasons for this will be discussed.}
doi = {10.1016/0360-3016(95)97830-T}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}
title = {A pilot study of accelerated superfractionated radiotherapy for locally advanced cancer of the uterine cervix}
author = {Gieschen, H, Kavanagh, B, Kaufman, N, West, R, Goplerud, D, and Schmidt-Ullrich, R}
abstractNote = {Purpose: Retrospective studies have suggested that overall treatment time is an important determinant of outcome for locally advanced squamous carcinoma of the cervix managed with definitive radiotherapy. We initiated a prospective clinical trial to test the hypothesis that minimizing treatment time can prevent tumor cell repopulation in squamous cell carcinoma of the cervix. Materials and Methods: Between 1989 and 1994 twenty two patients with FIGO stage IIIA to IVA squamous cell carcinoma of the cervix were treated as follows: Forty-five Gy was delivered to the whole pelvis in 25 fractions in 5 weeks using photon energies of 6 MV or greater. On Monday, Wednesday, and Friday of each of the last three weeks of treatment, a boost treatment of 1.6 Gy was given via small lateral parallel opposed fields, six hours after the first fraction. Thus, the total dose to the tumor and parametrial region was 59.4 Gy. A single brachytherapy procedure (Standard Tandem and Ovoids or Interstitial Template) was performed one week after the completion of external beam radiotherapy to bring the point A dose to 90 Gy in 6 weeks. Results: With a median follow-up of 30 months, (range: 5 to 42 months) the actuarial 3 year overall survival is 61.5% and the disease-free survival is 51.4%. Two out of twenty two patients (9.1%) had loco-regional failure alone, (5(22)) (22.7%) had distant failure only, and (4(22)) (18.2%) had both. The actuarial loco-regional control at 3 years is 69.5% with a distant metastasis-free survival of 57.5%. The median length of treatment was 46 days with a range of 35 to 107 days Most of the patients had only mild acute reactions, mainly diarrhea. There were no severe acute reactions. Thirteen of 22 patients (59.1%) had no late complications. Three patients had chronic proctitis, one with intermittent bleeding. Six (27.3%) patients experienced severe late complications consisting of vesico-vaginal fistulas, recto-vaginal fistulas and small bowel obstruction. One patient experienced severe hip dysfunction. A detailed analysis of tumor burden, dose and treatment volume in patients with complications will be given. Conclusions: This new regimen delivers a high dose to point A over a short amount of time and decreases the time of hospitalization since only one brachytherapy procedure is performed. The overall survival, disease-free survival, local control and distant metastases rate are comparable to or better than results reported in the literature. However, a higher rate of late complications is observed with this regimen. Possible reasons for this will be discussed.}
doi = {10.1016/0360-3016(95)97830-T}
journal = []
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}