To investigate the local control and side effects of IMRT with 3D-CRT with concurrent chemotherapy in posthysterectomy cervical cancer patients treated with concurrent chemotherapy

Background and purpose:Intensity-modulated radiotherapy(IMRT) is a promising technology that can deliver a high dose of radiation in a more conformal manner,with relative spring of adjacent normal tissues.The purpose of this study was to assess local control and acute toxicity of IMRT and three dimensional conformal radiotherapy(3D-CRT) as adjuvant treatment of posthysterectomy cervical cancer.Methods:Between Jul.2005 and Nov.2010,61 patients at high risk or intermediate risk of cervical cancer after hysterectomy were treated with adjuvant pelvic radiotherapy and concurrent chemotherapy.Adjuvant chemotherapy consisted of cisplatin(25 mg/m2) per week.Twenty-six patients received adjuvant radiotherapy by 3D-CRT,35 patients by IMRT.All the patients received 45-50.4 Gy of external beam radiotherapy.The clinical data of the 2 groups were similar to each other.Results:The 1-and 3-year overall survival rates were 100% and 95.1% of all patients.Compared with 3D-CRT,IMRT provided compatible local tumor control.1-year locoregional control of IMRT and 3D-CRT groups were 94% and 92%,respectively.IMRT can be tolerated,and significant reduction the acute gastrointestinal(GI) and genitourinary(GU) toxicities(GI: 42.9% vs 80.9%,P=0.005;GU: 28.6% vs 57.7%,P=0.0034).And also less influence in the hematologic toxicities(P=0.006).Conclusion:Our results suggest that adjuvant treatment IMRT in early stage cervical cancer has similar local control but low acute toxicity.However,the true benefits of IMRT are needed longer follow-up and more patients.