Alam Nawed, Akram Mohammad, Siddiqui Shahid Ali, Hussain M A Bilal
Department of Radiotherapy, J. N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
J Cancer Res Ther. 2019 Oct-Dec;15(6):1254-1259. doi: 10.4103/jcrt.JCRT_301_17.
To decrease overall treatment time (OTT) and to compare the clinical outcome of interdigitated high-dose-rate intracavitary brachytherapy (HDRICBT) versus sequential HDRICBT with external beam radiotherapy (EBRT) in the treatment of locally advanced carcinoma cervix.
Eighty-two patients with histologically confirmed carcinoma of the cervix, untreated International Federation of Gynecology and Obstetrics Stage IIB-IIIB, were included and randomized into two groups. The study group received EBRT 50 Gy/25 fractions with interdigitated HDRICBT 8 Gy/fraction weekly a total of three fractions. Patients in the control group received EBRT 50 Gy/25 fractions with sequential HDRICBT 8 Gy/fraction weekly a total of three fractions. At the end of the study, results of both groups compared in terms of OTT, acute and late toxicities, and response to therapy clinically.
A total of 82 patients were enrolled 41 in each arm. Seventy-two patients completed treatment and were analyzed. Mean OTT in study group and control group was 40 and 60 days, respectively. The median follow-up duration was 10 months (3-18). Most of the acute and late toxicities were of Grade 1 and 2 type and comparable in both study and control groups. Treatment interruption due to treatment-related toxicity was slightly higher in the study group than the control group, but it was statistically insignificant. Os negotiability was not found to be a limiting factor for interdigitated HDRICBT.
Interdigitated HDRICBT has equivalent response and toxicities as sequential HDRICBT with the advantage of significant reduction in OTT.
减少总体治疗时间（OTT），并比较指叉式高剂量率腔内近距离放射治疗（HDRICBT）与高剂量率腔内近距离放射治疗序贯外照射放疗（EBRT）在治疗局部晚期宫颈癌中的临床疗效。
纳入82例经组织学确诊为宫颈癌、国际妇产科联盟（FIGO）分期为IIB-IIIB期且未经治疗的患者，并随机分为两组。研究组接受EBRT 50 Gy/25次分割，同时每周进行指叉式HDRICBT，每次8 Gy，共三次分割。对照组接受EBRT 50 Gy/25次分割，同时每周序贯进行HDRICBT，每次8 Gy，共三次分割。在研究结束时，比较两组在OTT、急性和晚期毒性以及临床治疗反应方面的结果。
共纳入82例患者，每组41例。72例患者完成治疗并进行分析。研究组和对照组的平均OTT分别为40天和60天。中位随访时间为10个月（3-18个月）。大多数急性和晚期毒性为1级和2级，研究组和对照组相当。研究组因治疗相关毒性导致的治疗中断略高于对照组，但无统计学意义。未发现骨可动性是指叉式HDRICBT的限制因素。
指叉式HDRICBT与序贯HDRICBT具有相同的治疗反应和毒性，且具有显著缩短OTT的优势。
