Cervical Cancer - Brachytherapy

INTRODUCTION Cervical carcinoma has traditionally been treated with low-dose-rate brachytherapy. High-dose-rate brachytherapy was developed to overcome potential disadvantages of LDR brachytherapy (radiation exposure to medical staff, prolonged treatment time, mandatory hospitalization and applicator movement). Both, LDR and HDR brachytherapy have been combined with the external beam therapy (EBT). At the Institute for Oncology and Radiology of Serbia in Belgrade, the treatment of the cervical carcinoma with the radiological methods has been existing for more than 70 years. Intracavitary brachytherapy of this malignancy with gamma emitters began in 1932 using Ra-226 (LDR). Co-60 sources were introduced in the clinical practice in 1964 and Cs-137 (LDR) in 1977. The Parisian technique was applied in 1964, when a modification of the Manchester technique was introduced. External pelvic irradiation has continuously been applied for the treatment of the cervical carcinoma: ortovoltage patients with gynecological malignancy were irradiated at the Institute for Oncology and Radiology of Serbia in Belgrade using HDR afterloading technique: From this clinical material we made a retrospective analysis of 1,330 patients with the cervical carcinoma treated with HDR brachytherapy (Table 1). From July 1, 1997 to August 31, 1978, a group of 187 patients with the cervical carcinoma have been irradiated radically using manual Cs-137 LDR afterloading technique (Table 1).