International Journal of Radiation Oncology * Biology * Physics
Volume 76, Issue 3 , Pages 713-718 , 1 March 2010

Late Effects After Radiotherapy for Locally Advanced Cervical Cancer: Comparison of Two Brachytherapy Schedules and Effect of Dose Delivered Weekly

  • Taran Paulsen Hellebust, M.Sc.

      Affiliations

    • Department of Medical Physics, Division of Cancer Medicine and Radiotherapy, Institute for Cancer Research, Radiumhospitalet, Rikshospitalet University Hospital, Oslo, Norway
    • Department of Physics, University of Oslo, Oslo, Norway
    • Corresponding Author InformationReprint requests to: Taran Paulsen Hellebust, M.Sc., Department of Medical Physics, Division of Cancer Medicine and Radiotherapy, Radiumhospitalet, Rikshospitalet University Hospital, Oslo 0310 Norway. Tel: (+47) 2278-1140; Fax: (+47) 2278-1102
  • ,
  • Gunnar B. Kristensen, M.D., Ph.D.

      Affiliations

    • Department of Gynaecological Oncology, Division of Obstetrics and Gynaecology, Institute for Cancer Research, Radiumhospitalet, Rikshospitalet University Hospital, Oslo, Norway
    • Institute for Medical Informatics, Institute for Cancer Research, Radiumhospitalet, Rikshospitalet University Hospital, Oslo, Norway
  • ,
  • Dag Rune Olsen, Ph.D.

      Affiliations

    • Department of Physics, University of Oslo, Oslo, Norway
    • Department of Radiation Biology, Institute for Cancer Research, Radiumhospitalet, Rikshospitalet University Hospital, Oslo, Norway

Received 29 September 2008 ,Revised 11 February 2009 ,Accepted 11 February 2009.

References 

  1. Petereit DG, Pearcey R. Literature analysis of high dose rate brachytherapy fractionation schedules in the treatment of cervical cancer: Is there an optimal fractionation schedule?. Int J Radiat Oncol Biol Phys. 1999;43:359–366
  2. Pötter R, Dimopoulos J, George P, et al. Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer. Radiother Oncol. 2007;83:148–155
  3. Ota T, Takeshima N, Tabata T, et al. Treatment of squamous cell carcinoma of the uterine cervix with radiation therapy alone: Long-term survival, late complications, and incidence of second cancers. Br J Cancer. 2007;97:1058–1062
  4. Noda S, Ohno T, Kato S, et al. Late rectal complications evaluated by computed tomography-based dose calculations in patients with cervical carcinoma undergoing high-dose-rate brachytherapy. Int J Radiat Oncol Biol Phys. 2007;69:118–124
  5. Wang CJ, Huang EY, Sun LM, et al. Clinical comparison of two linear-quadratic model-based isoeffect fractionation schemes of high-dose-rate intracavitary brachytherapy for cervical cancer. Int J Radiat Oncol Biol Phys. 2004;59:179–189
  6. Ferrigno R, Novaes PE, Pellizzon AC, et al. High-dose-rate brachytherapy in the treatment of uterine cervix cancer: Analysis of dose effectiveness and late complications. Int J Radiat Oncol Biol Phys. 2001;50:1123–1135
  7. Chen SW, Ljang JA, Yeh LS, et al. Comparative study of reference points by dosimetric analyses for late complications after uniform external radiotherapy and high-dose-rate brachytherapy for cervical cancer. Int J Radiat Oncol Biol Phys. 2004;60:663–671
  8. Mosalaei A, Mohammadianpanah S, Ahmadloo ON. High-dose rate brachytherapy in the treatment of carcinoma of uterine cervix: Twenty-year experience with cobalt after-loading system. Int J Gynecol Cancer. 2006;16:1101–1105
  9. Weiss E, Hirnle P, Arnold-Bofinger H, et al. Therapeutic outcome and relation of acute and late side effects in the adjuvant radiotherapy of endometrial carcinoma stage I and II. Radiother Oncol. 1999;53:37–44
  10. Wang CJ, Leung SW, Chen HC, et al. The correlation of acute toxicity and late rectal injury in radiotherapy for cervical carcinoma: Evidence suggestive of consequential late effect (CQLE). Int J Radiat Oncol Biol Phys. 1998;40:85–91
  11. Schultheiss TE, Lee WR, Hunt MA, et al. Late GI and GU complications in the treatment of prostate cancer. Int J Radiat Oncol Biol Phys. 1997;37:3–11
  12. Dörr W, Hendry JH. Consequential late effects in normal tissues. Radiother Oncol. 2001;61:223–231
  13. Wilkinson JM, Moore CJ, Notley HM, et al. The use of Selectron afterloading equipment to simulate and extend the Manchester System for intracavitary therapy of the cervix uteri. Br J Radiol. 1983;56:409–414
  14. International Commission on Radiation Units and Measurements. ICRU report 38: Dose and volume specification for reporting intracavitary therapy in gynecology. Washington, DC: ICRU; 1985;
  15. Sakata KI, Nagakura H, Oouchi A, et al. High-dose-rate intracavitary brachytherapy: Results of analyses of late rectal complications. Int J Radiat Oncol Biol Phys. 2002;54:1369–1376
  16. Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys. 1995;31:1341–1346
  17. Huang EY, Wang CJ, Hsu HC, et al. Dosimetric factors predicting severe radiation-induced bowel complications in patients with cervical cancer: Combined effect of external parametrial dose and cumulative rectal dose. Gynecol Oncol. 2004;95:101–108
  18. Chen SW, Liang JA, Yang SN, et al. The prediction of late rectal complications following the treatment of uterine cervical cancer by high-dose-rate brachytherapy. Int J Radiat Oncol Biol Phys. 2000;47:955–961
  19. Ogino I, Kitamura T, Okamoto N, et al. Late rectal complication following high dose rate intracavitary brachytherapy in cancer of the cervix. Int J Radiat Oncol Biol Phys. 1995;31:725–734
  20. van Lancker M, Storme G. Prediction of severe late complications in fractionated, high dose-rate brachytherapy in gynecological applications. Int J Radiat Oncol Biol Phys. 1991;20:1125–1129
  21. Crook JM, Esche BA, Chaplain G, et al. Dose-volume analysis and the prevention of radiation sequelae in cervical cancer. Radiother Oncol. 1987;8:321–332
  22. Toita T, Kakinohana Y, Ogawa K, et al. Combination external beam radiotherapy and high-dose-rate intracavitary brachytherapy for uterine cervical cancer: Analysis of dose and fractionation schedule. Int J Radiat Oncol Biol Phys. 2003;56:1344–1353
  23. Kim TH, Chol J, Park SY, et al. Dosimetric parameters that predict late rectal complications after curative radiotherapy in patients with uterine cervical carcinoma. Cancer. 2005;104:1304–1311
  24. Chun M, Kang S, Kil HJ, et al. Rectal bleeding and its management after irradiation for uterine cervical cancer. Int J Radiat Oncol Biol Phys. 2004;58:98–105
  25. Clark BG, Souhami L, Roman TN, et al. The prediction of late rectal complications in patients treated with high dose-rate brachytherapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys. 1997;38:989–993
  26. Wong FCS, Tung SY, Leung TW, et al. Treatment results of high-dose-rate remote afterloading brachytherapy for cervical cancer and retrospective comparison of two regimens. Int J Radiat Oncol Biol Phys. 2003;55:1254–1264
  27. Cheng JCH, Peng LC, Chen YH, et al. Unique role of proximal rectal dose in late rectal complications for patients with cervical cancer undergoing high-dose-rate intracavitary brachytherapy. Int J Radiat Oncol Biol Phys. 2003;57:1010–1018
  28. Hellebust TP, Dale E, Skjonsberg A, et al. Interfraction variations in rectum and bladder volumes and dose distributions during high dose rate brachytherapy treatment of the uterine cervix investigated by repetitive CT-examinations. Radiother Oncol. 2001;60:273–280
  29. Heie-Meder C, Pötter R, van Limbergen E, et al. Recommendations from the Gynaecological (GYN) GEC ESTRO Working Group (I): Concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol. 2005;74:235–245
  30. Pötter R, Heie-Meder C, van Limbergen E, et al. Recommendations from the Gynaecological (GYN) GEC ESTRO Working Group (II): Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy—3D volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiother Oncol. 2006;78:67–77
  31. Nag S, Cardenes H, Chang S, et al. Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: report from image-guided brachytherapy working group. Int J Radiat Oncol Biol Phys. 2004;60:1160–1172
  32. Koom WS, Sohn DK, Kim JY, et al. Computed tomography-based high-dose-rate intracavitary brachytherapy for uterine cervical cancer: Preliminary demonstration of correlation between dose-volume parameters and rectal mucosal changes observed by flexible sigmoidoscopy. Int J Radiat Oncol Biol Phys. 2007;68:1446–1454
  33. Hall EJ. Radiology for the radiologist. 5th ed.. Philadelphia: Lippincott Williams & Wilkins; 2000;

 Funded by South-Eastern Norway Regional Health Authority.

 Conflict of interest: none.

PII: S0360-3016(09)00255-7

doi: 10.1016/j.ijrobp.2009.02.024

International Journal of Radiation Oncology * Biology * Physics
Volume 76, Issue 3 , Pages 713-718 , 1 March 2010