Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients
<p>Abstract</p> <p>Background</p> <p>A current paradigm in the treatment of cervical cancer with radiation therapy is that intracavitary brachytherapy is an essential component of radical treatment. This is a matched retrospective comparison of the results of treatment...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2009-02-01
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| Series: | World Journal of Surgical Oncology |
| Online Access: | http://www.wjso.com/content/7/1/19 |
| _version_ | 1811257917724164096 |
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| author | Flores Vladimir Bazan-Perkins Blanca Coronel Jaime Rivera Lesbia Cantú David Candelaria Myrna Garcia-Arias Alicia Cetina Lucely Gonzalez Aaron Dueñas-González Alfonso |
| author_facet | Flores Vladimir Bazan-Perkins Blanca Coronel Jaime Rivera Lesbia Cantú David Candelaria Myrna Garcia-Arias Alicia Cetina Lucely Gonzalez Aaron Dueñas-González Alfonso |
| author_sort | Flores Vladimir |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>A current paradigm in the treatment of cervical cancer with radiation therapy is that intracavitary brachytherapy is an essential component of radical treatment. This is a matched retrospective comparison of the results of treatment in patients treated with external beam chemoradiation (EBRT-CT) and radical hysterectomy versus those treated with identical chemoradiation followed by brachytherapy.</p> <p>Methods</p> <p>In this non-randomized comparison EBRT-CT protocol was the same in both groups of 40 patients. In the standard treated patients, EBRT-CT was followed by one or two intracavitary Cesium (low-dose rate) applications within 2 weeks of finishing external radiation to reach a point A dose of at least 85 Gy. In the surgically treated patients, radical hysterectomy with bilateral pelvic lymph node dissection and para-aortic lymph node sampling were performed within 7 weeks after EBRT-CT. Response, toxicity and survival were evaluated.</p> <p>Results</p> <p>A total of 80 patients were analyzed. The patients receiving EBRT-CT and surgery were matched with the standard treated cases. There were no differences in the clinicopathological characteristics between groups or in the delivery of EBRT-CT. The pattern of acute and late toxicity differed. Standard treated patients had more chronic proctitis while the surgically treated had acute complications of surgery and hydronephrosis. At a maximum follow-up of 60 months, median follow-up 26 (2–31) and 22 (3–27) months for the surgery and standard therapy respectively, eight patients per group have recurred and died. The progression free and overall survival are the same in both groups.</p> <p>Conclusion</p> <p>The results of this study suggest that radical hysterectomy can be used after EBRT-CT without compromising survival in FIGO stage IB2-IIB cervical cancer patients in settings were brachytherapy is not available. A randomized study is needed to uncover the value of surgery after EBRT-CT.</p> |
| first_indexed | 2024-04-12T18:06:03Z |
| format | Article |
| id | doaj.art-293337b834b14b18a03f688d664428c8 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-12T18:06:03Z |
| publishDate | 2009-02-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-293337b834b14b18a03f688d664428c82022-12-22T03:22:00ZengBMCWorld Journal of Surgical Oncology1477-78192009-02-01711910.1186/1477-7819-7-19Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patientsFlores VladimirBazan-Perkins BlancaCoronel JaimeRivera LesbiaCantú DavidCandelaria MyrnaGarcia-Arias AliciaCetina LucelyGonzalez AaronDueñas-González Alfonso<p>Abstract</p> <p>Background</p> <p>A current paradigm in the treatment of cervical cancer with radiation therapy is that intracavitary brachytherapy is an essential component of radical treatment. This is a matched retrospective comparison of the results of treatment in patients treated with external beam chemoradiation (EBRT-CT) and radical hysterectomy versus those treated with identical chemoradiation followed by brachytherapy.</p> <p>Methods</p> <p>In this non-randomized comparison EBRT-CT protocol was the same in both groups of 40 patients. In the standard treated patients, EBRT-CT was followed by one or two intracavitary Cesium (low-dose rate) applications within 2 weeks of finishing external radiation to reach a point A dose of at least 85 Gy. In the surgically treated patients, radical hysterectomy with bilateral pelvic lymph node dissection and para-aortic lymph node sampling were performed within 7 weeks after EBRT-CT. Response, toxicity and survival were evaluated.</p> <p>Results</p> <p>A total of 80 patients were analyzed. The patients receiving EBRT-CT and surgery were matched with the standard treated cases. There were no differences in the clinicopathological characteristics between groups or in the delivery of EBRT-CT. The pattern of acute and late toxicity differed. Standard treated patients had more chronic proctitis while the surgically treated had acute complications of surgery and hydronephrosis. At a maximum follow-up of 60 months, median follow-up 26 (2–31) and 22 (3–27) months for the surgery and standard therapy respectively, eight patients per group have recurred and died. The progression free and overall survival are the same in both groups.</p> <p>Conclusion</p> <p>The results of this study suggest that radical hysterectomy can be used after EBRT-CT without compromising survival in FIGO stage IB2-IIB cervical cancer patients in settings were brachytherapy is not available. A randomized study is needed to uncover the value of surgery after EBRT-CT.</p>http://www.wjso.com/content/7/1/19 |
| spellingShingle | Flores Vladimir Bazan-Perkins Blanca Coronel Jaime Rivera Lesbia Cantú David Candelaria Myrna Garcia-Arias Alicia Cetina Lucely Gonzalez Aaron Dueñas-González Alfonso Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients World Journal of Surgical Oncology |
| title | Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients |
| title_full | Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients |
| title_fullStr | Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients |
| title_full_unstemmed | Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients |
| title_short | Brachytherapy versus radical hysterectomy after external beam chemoradiation: a non-randomized matched comparison in IB2-IIB cervical cancer patients |
| title_sort | brachytherapy versus radical hysterectomy after external beam chemoradiation a non randomized matched comparison in ib2 iib cervical cancer patients |
| url | http://www.wjso.com/content/7/1/19 |
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