192)Ir afterloading intracavitary brachytherapy and external beam radiotherapy for carcinoma of uterine cervix

Objective To study the therapeutic effect and complications of cervical carcinoma treated with 192 Ir afterloading intracavitary irradiation plus external beam radiation therapy (EBRT). Methods From June 1994 to March 1997,118 stage Ⅱ Ⅲ cervical cancer patients confirmed pathologically were treated with combination of HDR 192 Ir afterloading intracavitary brachytherapy plus EBRT. A midplane dose of 26 40?Gy to the whole pelvis and additional 20 25?Gy EBRT to the parametrical areas were given. Intracavitary brachytherapy was delivered to a total dose of 36 42?Gy at 6?Gy per fraction ,once a week. Results All patients were followed up over five years. The 3 and 5 year survival rates were 83.1% and 72.0%. The 5 year survival rates for stage Ⅱ and stage Ⅲ lesions were 80.6% and 58.7% (P0.05). Immediate rectal reaction and late radioproctitis were present in 13.6% and 15.3%, acute and chronic radiation cystitis in 5.9% and 4.2%, respectively. Rectovaginal fistula developed in 0.9%. Conclusion HDR afterloading Intracavitary brachytherapy combined with external radiation is effective with equitable complications in the treatment of carcinoma of uterine cervix.