Effect of Three Dimensional Conformal Radiotherapy Combined with Intracavitary Brachtherapy in Treatment of Cervical Cancer

Abstract

Objective To explore the effect and complications of all course three dimensional conformal radiotherapy(3DCRT) combined with intracavitary brachytherapy in the treatment of cervical cancer.Methods Sixty cervical cancer patients were randomly divided randomly into two groups.First,all patients accepted 3D conformal radiotherapy in the 3DCRT group,when whole pelvic received 40Gy,a planning CT scan of each patient was obtained.And second 3DCRT therapy plans were taken.Then continued to irradiate with 50Gy.Finally,3DCRT boost local involved volumes to the total dose of 60Gy.When 3DCRT combined with intracavitary branchtherapy,the dose of branchytherapy to point A was 30Gy/5fraction.In the conventional group after a total tumour dose of 40Gy was delivered by whole pelvic irradiation,the four-field technique was used to irradiate the parametrial tissue and regional nodes(median dose of 10Gy),the invovlved volumes were boosted to 60Gy and combined with intracavitary branchtherapy,(the dose of branchytherapy to point A was(30~36)Gy/(5~6)fraction).In two groups two cycle chemotherapy were given concurrently with radiotherapy in the first week and the last week,respectively.Results The 1,2,3-year survival rate for 3DCRT group and conventional group were 96.7%,93.3%,90.0% and 86.6%,76.7%,and 70% respectively(P=0.04,P=0.02 and P=0.02).There was significant difference.The toxic effects were compared in two group,except the Ⅰ~Ⅱ grade rectal and bladder reaction and pelvic fibrosis which was lower in the 3DCRT group(P=0.007,P=0.006 and P=0.015),the side effects were similar and well tolerated in two groups.Conclusion The all course three dimensional conformal radiotherapy combined with intracavitary brachytherapy can be considered as an effective and feasible approach to cervical cancer and may significantly improve the survival rate and reduce the late toxicity.