Efficacy and safety of the CT-guided three-dimensional brachytherapy combined with three-dimensional conformal radiotherapy in patients with locally middle- and late-stage cervical cancer / 肿瘤

ABSTRACT

Objective: This study aims to investigate the efficacy and safety of the CT-guided three-dimensional brachytherapy combined with three-dimensional conformal radiotherapy in patients with locally middle- and late-stage cervical cancer. Methods: Ninety-seven patients with stage II A-IV locally middle- and late- stage cervical squamous-cell carcinoma were treated with CT-guided three-dimensional brachytherapy combined with three-dimensional conformal radiotherapy. The short-term response was observed. The survival analysis was conducted by Kaplan-Meier method, and the univariate analysis of prognosis was performed by using log-rank test. The high-risk clinical target volume (HR-CTV) D90, D2cc of bladder, rectum and sigmoid colon and equivalent dose in 2 Gy per fraction (EQD2) were calculated. Results: The overall 2-year survival rate and 2-year progression-free survival rate of 97 patients were 93.8% and 92.1%, respectively. The differentiation degree and tumor size were significantly correlated with the overall survival (both P < 0.05). According to Radiation Therapy Oncology Group (RTOG) acute and late radiation reaction evaluation criterion, rates of grades 1 and 2 acute lower digestive adverse reaction were 15.5% (15/97) and 12.4% (12/97), respectively. The acute gastrointestinal adverse reaction grading was associated with HR-CTV D90 EQD2 (P = 0.027). The rate of grades 3 and 4 late digestive system adverse reactions was 1.0% (1/97). Conclusion: CT-guided three-dimensional brachytherapy combined with three-dimensional conformal radiotherapy in the treatment of locally middle- and late-stage cervical cancer has good efficacy, and the rate of late severe adverse reaction is low.