External Beam Boost for Cancer of the Cervix Uteri When Intracavitary Therapy Cannot Be Performed

• Published in: International journal of radiation oncology, biology, physics Vol. 71; no. 3; pp. 772 - 778
• Main Authors: Barraclough, Lisa Helen, F.R.C.R, Swindell, Ric, M.Sc, Livsey, Jacqueline E., F.R.C.R, Hunter, Robin D., F.R.C.R, Davidson, Susan E., F.R.C.R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2008
• Subjects: Adult; Aged; Aged, 80 and over; BEAMS; BLADDER; BRACHYTHERAPY; Brachytherapy not possible; Cervix uteri; External beam boost; Female; GYNECOLOGY; Hematology, Oncology and Palliative Medicine; Humans; IRRADIATION; Middle Aged; NEOPLASMS; Outcome; PATIENTS; PELVIS; RADIATION DOSES; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Radiotherapy alone; Radiotherapy Dosage; Radiotherapy, Conformal - methods; Retrospective Studies; TOXICITY; Treatment Outcome; Uterine Cervical Neoplasms - radiotherapy; External beam boost; Cervix uteri; Radiotherapy alone; Brachytherapy not possible; Outcome
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2007.10.066

Purpose To assess the outcome of patients treated with radical radiotherapy for cervical cancer who received an external beam boost, in place of intracavitary brachytherapy (ICT), after irradiation to the whole pelvis. Methods and Materials Case notes were reviewed for all patients treated in this way in a single center between 1996 and 2004. Patient and tumor details, the reasons why ICT was not possible, and treatment outcome were documented. Results Forty-four patients were identified. The mean age was 56.4 years (range, 26–88 years). Clinical International Federation of Gynecology and Obstetrics or radiologic stage for Stages I, II, III, and IV, respectively, was 16%, 48%, 27%, and 7%. A total radiation dose of 54–70 Gy was given (75% received ≥60 Gy). Reasons for ICT not being performed were technical limitations in 73%, comorbidity or isolation limitations in 23%, and patient choice in 4%. The median follow-up was 2.3 years. Recurrent disease was seen in 48%, with a median time to recurrence of 2.3 years. Central recurrence was seen in 16 of the 21 patients with recurrent disease. The 5-year overall survival rate was 49.3%. The 3-year cancer-specific survival rate by stage was 100%, 70%, and 42% for Stages I, II, and III, respectively. Late Grades 1 and 2 bowel, bladder, and vaginal toxicity were seen in 41%. Late Grade 3 toxicity was seen in 2%. Conclusion An external beam boost is a reasonable option after external beam radiotherapy to the pelvis when it is not possible to perform ICT.