BRACHYTHERAPY RESULT OF THE LOCALLY ADVANCED STAGE CERVICAL CARCINOMA: EXPERIENCE OF THE CERRAHPAŞA MEDICAL FACULTY

To evaluate the local control, survival results and complications of treatment with HDR compared to LDR brachytherapy in locally advanced cervical carcinoma, stages IIB-IIIB 320 patients who had no received chemotherapy or radiosensitiser have been analyzed, retrospectively. 253 and 67 cases were treated with high and low dose rate, respectively. In each group, all patients first received external pelvic irradiation. Total pelvic doses were 50.4 or 54 Gy in 5-6 weeks. No central shielding was used. Intracavitary irradiation was started one week after the completion of external irradiation. In LDR group, intracavitary treatment was given with Manchester applicators loaded with radium, 30 mg in an intrauterine tube and 20 mg in vaginal ovoids. Dose delivered to point A was on average 32 Gy in one application. In HDR group, total dose of 24 Gy was given to point A in three insertions one week apart. Dose rate was 0.62 Gy at point A. In HDR group, 5-year pelvic control rates in stages IIB, IIIA and IIIB were found 67%, 56% and 45%, respectively. In LDR group, these rates were 65%, 0% and 53%, respectively (p>0.05). 42 Late complications in 36 patients in HDR group and 10 late complications were seen in 8 patients in LDR group (p>0.05). HDR bracthyherapy in the management of the cervix appears as a safe and efficiaous approach. Pelvic control, survival and complications rates are quite similar when compared with LDR.

Keywords: cervical carcinoma, brachytherapy, retrospective analysis