Abstract
Objective To evaluate the clinical efficacy and safety of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) to the tumor center in the treatment of bulky cervical cancer with massive bleeding in the first course radiotherapy. Methods Twenty-one cases with bulky cervical cancer complicated with massive vaginal bleeding were enrolled. At the first three times of external irradiation, a high dose radiotherapy (15 Gy/3 fractions) was delivered to the tumor center (the region retracted 2 cm from the periphery of cervical mass), followed by conventional irradiation (2 Gy/fraction) in the posterior course. Conventional dose irradiation (46 Gy/23 fractions) was given to the tumor periphery and pelvic lymphatic drainage area throughout the whole course. Concurrent chemotherapy by cisplatin at a dose of 25 mg/m2 was delivered weekly. After the external irradiation, intracavitary radiotherapy was given (20 Gy/4 fractions). Results Within 24 h after the first course radiotherapy, the volume of vaginal bleeding was significantly decreased by 50% and the bleeding was almost stopped within one week. The hemostasis rate was 100%. Conclusions SIB-IMRT into the center of bulky cervical cancer is an efficacious treatment of massive vaginal bleeding. Key words: Cervical neoplasm/simultaneous integrated boost intensity-modulated radiotherapy; Massive bleeding; Hemostasis
Published Version
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