High-dose-rate interstitial brachytherapy for previously untreated cervical carcinoma

Purpose: The aim of the study was to evaluate the results of high-dose-rate interstitial brachytherapy (HDR-ISBT) for patients with advanced cervical carcinoma in which intracavitary radiation therapy may result in a suboptimal dose distribution. Methods and Materials: Between 1995 and 2005, 25 patients of median age 64 years were treated with external beam radiation therapy and HDR-ISBT. The International Federation of Gynecology and Obstetrics stages of the patients were I (4%), II (16%), III (68%), and IVA (12%). Whole pelvic irradiation of 30 Gy/15 fractions was followed by HDR-ISBT of 30 Gy/5 fractions/3 days. Subsequently, additional pelvic external beam radiation therapy of 20 Gy/10 fractions was delivered with a midline block. The median followup period was 55 months. Results: The actuarial 5-year progression-free survival and overall survival rates for all cases were 42% and 54%, respectively. For the 17 patients with a Stage III tumor, the 5-year local control and overall survival rates were 73% and 51%, respectively. Two patients (8%) developed late toxicities of Grade 3. Conclusions: A high rate of pelvic control and survival with acceptable level of late toxicities were obtained for patients with advanced cervical carcinoma treated with HDR-ISBT.