The effects of ~(192)Ir afterloading brachytherapy combined with external beam radiotherapy on 123 cases with stage IIor III cervical cancer

Objective:To evaluate the curative effects of 192Ir afterloading brachytherapy combined with external beam radiation therapy(EBRT) in treatment of stage Ⅱor Ⅲ cervical carcinoma. Methods:One hundred twenty-three patients with stage Ⅱ～Ⅲ(FIGO)cervical carcinoma confirmed by pathology were treated with HDR 192Ir afterloading brachytherapy combined with EBRT.The front and rear pelvic cavity was irradiated at the dose of 1.8 to 2 Gy everytime,five times per week.Pelvic plane center was treated with the dose of 30 to 32 Gy for 3 to 3.5 weeks.The 3 cms lead was placed among pelvic cavity,the dose of 20 to 24 Gy for 2.5 to 3.5 weeks was added to near the uterus,and brachytherapy was employed with the dose of 18 to 24 Gy for 3 to 4 times and lasting 2.5 to 3.5 weeks.The dose of 12 to 18 Gy for 2 to 3 times and lasting 2.5 to 3.5 weeks was applied.The total doses of brachytherapy were 30 to 42 Gy for 5 to 6.5 weeks(point A). Results:All patients were followed up over 5 years,the survival rates were 62.6%.The 5-year survival rates of stage Ⅱand stage Ⅲ were 68% and 45.8%,respectively.When RTOG/EROTC was more than or equal to 2,the injury incidence of rectum,bladder and rectosigmoid were 22 patients,8 patients and 40 patients,respectively.The incidence of rectovaginal fistula was 2 patients. Conclusions:The curative effects of stage Ⅱor Ⅲ cervical carcinoma treated with 192Ir afterloading brachytherapy combined with EBRT are good,convenient and high incidence of rectum injury.The scheme of near distance treatment as a whole is safe.