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Comparing efficacy of high-dose rate brachytherapy versus helical tomotherapy in the treatment of cervical cancer

Authors
Kim, SeongminLee, SanghoonHong, Jin HwaPark, Young JeSong, Jae YunLee, Jae KwanLee, Nak Woo
Issue Date
Jul-2020
Publisher
대한부인종양학회
Keywords
Brachytherapy; Helical Tomotherapy; Cervical Cancer; Concomitant Chemoradiotherapy
Citation
Journal of Gynecologic Oncology, v.31, no.4
Indexed
SCIE
SCOPUS
KCI
Journal Title
Journal of Gynecologic Oncology
Volume
31
Number
4
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/28059
DOI
10.3802/jgo.2020.31.e42
ISSN
2005-0380
Abstract
Objective: Boost radiation using brachytherapy (BT) is a standard treatment for local disease control in concomitant chemoradiation therapy (CCRT) for advanced cervical cancer. However, it is associated with gastrointestinal and genitourinary complications. Hence, this study investigates the feasibility of helical tomotherapy (HT) as an alternative to BT. Methods: Medical records of patients who underwent CCRT between 2000 and 2017 at a single institution were retrospectively reviewed. Patients with stage IIB-IVA cancers were selected based on the 2009 criteria of The International Federation of Gynaecology and Obstetrics. External beam radiation combined with chemotherapy was followed by either BT or HT. The propensity score matching of both groups was calculated using logistic regression analysis. Disease outcomes and treatment-related adverse events were compared between the 2 groups. Results: The matched population included 70 BT patients and 35 HT patients. The 5-year progression-free survival rates for BT and HT were 72.6% and 72.5%, respectively (p=0.721). There was no difference in the overall survival rate between the two groups (p=0.203). The presence of acute and chronic gastrointestinal complications was also similar between the groups (p=0.460 and p=0.563, respectively). The chronic genitourinary toxicities were also comparable (p=0.105). Conclusions: HT boost treatment showed comparable disease outcomes with those observed with conventional BT in patients with advanced cervical cancer. HT could be a complementary boost protocol as a single modality or hybrid with BT in selected patients. Further studies with longer follow-up periods are warranted to confirm long-term outcomes.
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2. Clinical Science > Department of Radiation Oncology > 1. Journal Articles
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Hong, Jin Hwa
Guro Hospital (Department of Obstetrics and Gynecology, Guro Hospital)
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