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Comparing efficacy of high-dose rate brachytherapy versus helical tomotherapy in the treatment of cervical cancer : .

Comparing efficacy of high-dose rate brachytherapy versus helical tomotherapy in the treatment of cervical cancer

초록/요약

Objective: Boost radiation using brachytherapy (BT) is a standard treatment for local diseasecontrol in concomitant chemoradiation therapy (CCRT) for advanced cervical cancer. However, it is associated with gastrointestinal and genitourinary complications. Hence, thisstudy investigates the feasibility of helical tomotherapy (HT) as an alternative to BT. Methods: Medical records of patients who underwent CCRT between 2000 and 2017 at a singleinstitution were retrospectively reviewed. Patients with stage IIB–IVA cancers were selectedbased on the 2009 criteria of The International Federation of Gynaecology and Obstetrics. External beam radiation combined with chemotherapy was followed by either BT or HT. Thepropensity score matching of both groups was calculated using logistic regression analysis. Disease outcomes and treatment-related adverse events were compared between the 2 groups. Results: The matched population included 70 BT patients and 35 HT patients. The 5-yearprogression-free survival rates for BT and HT were 72.6% and 72.5%, respectively (p=0.721). There was no difference in the overall survival rate between the two groups (p=0.203). Thepresence of acute and chronic gastrointestinal complications was also similar between thegroups (p=0.460 and p=0.563, respectively). The chronic genitourinary toxicities were alsocomparable (p=0.105). Conclusions: HT boost treatment showed comparable disease outcomes with thoseobserved with conventional BT in patients with advanced cervical cancer. HT could be acomplementary boost protocol as a single modality or hybrid with BT in selected patients. Further studies with longer follow-up periods are warranted to confirm long-term outcomes.

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