Abstract
BackgroundTo review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer.MethodsBetween November 1st, 2006 and May 31, 2009, 10 cervical cancer patients histologically confirmed were enrolled. All of the patients received definitive concurrent chemoradiation (CCRT) with whole pelvic HT (WPHT) followed by brachytherapy. During WPHT, all patients were treated with cisplatin, 40 mg/m2 intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0).ResultsThe mean survival was 25 months (range, 3 to 27 months). The actuarial overall survival, disease-free survival, locoregional control and distant metastasis-free rates at 2 years were 67%, 77%, 90% and 88%, respectively. The average of uniformity index and conformal index was 1.06 and 1.19, respectively. One grade 3 of acute toxicity for diarrhea, thrombocytopenia and three grade 3 leucopenia were noted during CCRT. Only one grade 3 of subacute toxicity for thrombocytopenia was noted. There were no grade 3 or 4 subacute toxicities of anemia, leucopenia, genitourinary or gastrointestinal effects. Compared with conventional whole pelvic radiation therapy (WPRT), WPHT decreases the mean dose to rectum, bladder and intestines successfully.ConclusionHT provides feasible clinical outcomes in locally advanced cervical cancer patients. Long-term follow-up and enroll more locally advanced cervical carcinoma patients by limiting bone marrow radiation dose with WPHT technique is warranted.
Highlights
To review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer
Radiotherapy Radiotherapy was administered to the whole pelvic region in 28 fractions totaling 50.4 Gy followed by intracavitary brachytherapy
planning target volume (PTV), we evaluated the volume, the volume covered by 95% of the prescription dose (V95), and the minimum doses delivered to 5% (D5) and 95% (D95) of the PTV
Summary
To review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer. Cervical cancer is the second most frequent cancer among women worldwide [1]. It has demonstrated the superiority of combined chemotherapy with radiotherapy (RT) in the treatment of advanced cervix cancer [2,3]. A significant benefit of chemoradiation on both overall survival and progress-free survival rate was mentioned [4]. Grade 3 or 4 haematological (white cell count, 16% vs 8%; platelets, 1·5% vs 0·2%; haematological not otherwise specified, 29% vs 1%) and gastrointestinal toxicities (9% vs 4%) significantly greater in the concomitant chemoradiation group than the RT alone group should be mentioned. Tan et al [5] proposed a late toxicity observation for concomitant chemoradiation of locally advanced cervical cancer. There were 14.5%, 9.4% and 11.4% for grade 3 or 4 urinary, bowel and affecting other organs complications, respectively
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