Efficacy and toxicity of concomitant cisplatin with external beam pelvic radiotherapy and two high-dose-rate brachytherapy insertions for the treatment of locally advanced cervical cancer

Akiva P. Novetsky, Mark H. Einstein, Gary L. Goldberg, Susan M. Hailpern, Evan Landau, Abbie L. Fields, Subhakar Mutyala, Shalom Kalnicki, Madhur K. Garg

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective.: There is no standard high-dose-rate (HDR) brachytherapy dose for locally advanced cervical cancer. The objective of this study was to determine the efficacy, toxicity and clinicopathologic predictive markers affecting survival using cisplatin (CDDP) concomitant with external beam pelvic radiotherapy (EBRT) and two 9-Gy HDR insertions for the treatment of locally advanced cervical cancer. Methods.: 77 consecutive patients with Stage IB2-IV cervical cancer treated with CDDP, EBRT and two 9-Gy HDR insertions were included. Kaplan-Meier methods and Cox proportional hazards models were applied for survival statistics. Results.: Median age was 53. 90% had squamous cell carcinoma. Median follow-up time was 3.5 years (range 0.5-12 years). Overall 5-year progression-free survival (PFS) was 75%. Local control rate and 5-year PFS were 88% and 83%, respectively, for Stages IB2/II, and 68% and 61%, respectively, for Stages III/IV. Grade 3/4 GI symptoms were the most common acute side effects (47%). Grade 3/4 late toxicities occurred in five (6%) patients. Conclusions.: HDR brachytherapy regimens consisting of two 9-Gy HDR insertions have similar efficacy and side effect profiles as other brachytherapy regimens for the treatment of cervical cancer with improved safety and patient convenience.

Original languageEnglish (US)
Pages (from-to)635-640
Number of pages6
JournalGynecologic Oncology
Volume105
Issue number3
DOIs
StatePublished - Jun 2007

Fingerprint

Brachytherapy
Uterine Cervical Neoplasms
Cisplatin
Radiotherapy
Disease-Free Survival
Survival
Therapeutics
Patient Safety
Proportional Hazards Models
Squamous Cell Carcinoma

Keywords

  • Cervical carcinoma
  • Concomitant chemoradiotherapy
  • HDR
  • High-dose rate brachytherapy
  • Radiotherapy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Efficacy and toxicity of concomitant cisplatin with external beam pelvic radiotherapy and two high-dose-rate brachytherapy insertions for the treatment of locally advanced cervical cancer. / Novetsky, Akiva P.; Einstein, Mark H.; Goldberg, Gary L.; Hailpern, Susan M.; Landau, Evan; Fields, Abbie L.; Mutyala, Subhakar; Kalnicki, Shalom; Garg, Madhur K.

In: Gynecologic Oncology, Vol. 105, No. 3, 06.2007, p. 635-640.

Research output: Contribution to journalArticle

Novetsky, Akiva P. ; Einstein, Mark H. ; Goldberg, Gary L. ; Hailpern, Susan M. ; Landau, Evan ; Fields, Abbie L. ; Mutyala, Subhakar ; Kalnicki, Shalom ; Garg, Madhur K. / Efficacy and toxicity of concomitant cisplatin with external beam pelvic radiotherapy and two high-dose-rate brachytherapy insertions for the treatment of locally advanced cervical cancer. In: Gynecologic Oncology. 2007 ; Vol. 105, No. 3. pp. 635-640.
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abstract = "Objective.: There is no standard high-dose-rate (HDR) brachytherapy dose for locally advanced cervical cancer. The objective of this study was to determine the efficacy, toxicity and clinicopathologic predictive markers affecting survival using cisplatin (CDDP) concomitant with external beam pelvic radiotherapy (EBRT) and two 9-Gy HDR insertions for the treatment of locally advanced cervical cancer. Methods.: 77 consecutive patients with Stage IB2-IV cervical cancer treated with CDDP, EBRT and two 9-Gy HDR insertions were included. Kaplan-Meier methods and Cox proportional hazards models were applied for survival statistics. Results.: Median age was 53. 90{\%} had squamous cell carcinoma. Median follow-up time was 3.5 years (range 0.5-12 years). Overall 5-year progression-free survival (PFS) was 75{\%}. Local control rate and 5-year PFS were 88{\%} and 83{\%}, respectively, for Stages IB2/II, and 68{\%} and 61{\%}, respectively, for Stages III/IV. Grade 3/4 GI symptoms were the most common acute side effects (47{\%}). Grade 3/4 late toxicities occurred in five (6{\%}) patients. Conclusions.: HDR brachytherapy regimens consisting of two 9-Gy HDR insertions have similar efficacy and side effect profiles as other brachytherapy regimens for the treatment of cervical cancer with improved safety and patient convenience.",
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AU - Einstein, Mark H.

AU - Goldberg, Gary L.

AU - Hailpern, Susan M.

AU - Landau, Evan

AU - Fields, Abbie L.

AU - Mutyala, Subhakar

AU - Kalnicki, Shalom

AU - Garg, Madhur K.

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