Early results of exclusive radiotherapy in advanced stage cervical carcinoma performed with reference to ICRU Report 38.

BACKGROUND AND PURPOSE Most of the studies in which medium dose rate (MDR) or high dose rate (HDR) brachytherapy have been used for the treatment of cervical carcinoma were prescribed according to the Manchester system. This study aims to present early results of exclusive radiotherapy, which includes MDR brachytherapy, performed using ICRU 38 recommendations to their full extent. MATERIALS AND METHODS Between 1994 and 1997, 80 patients with advanced stage (FIGO stages IIA-IVA) cervical carcinoma received external beam therapy (EBT) to the pelvis at a total dose of 46 to 50 Gy and two fractions of MDR (approximately 11.5 Gy/h) brachytherapy delivered to the 60 Gy reference isodose. A dose correction factor of 0.80 was used for dose rate effect. Additionally, 10-14 Gy EBT was given as a parametrial boost. Mean follow-up duration was 25.7 months. RESULTS Local control (LC) and 3-year overall survival were 63% and 68%, respectively, for all patients. For stages II, III, and IV, LC was 75%, 44%, and 60% and 3-year survival was 75%, 62%, and 50%, respectively. Seven patients had severe late complications (8.7%). CONCLUSIONS The results of this study encourage the use of ICRU 38 recommendations with MDR or HDR brachytherapy with some additional measures in terms of the radiobiological aspect.