Evidence map›Paper›PMID 30971370›Full record

ArticleBrachytherapy

Concurrent chemoradiation for cervical cancer: Comparison of LDR and HDR brachytherapy.

Alexander J Lin, Pamela Samson, Jacqueline Zoberi, Jose Garcia-Ramirez, Jeffrey F Williamson, Stephanie Markovina, Julie Schwarz, Perry W Grigsby

Abstract read
In one paragraph

Article in Brachytherapy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Comparative analysis of LDR and HDR intracavitary brachytherapy in cervical cancer: the critical role of overall treatment time - a decade of experience.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alexander J LinDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO.
Pamela SamsonDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO.
Jacqueline ZoberiDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO.
Jose Garcia-RamirezDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO.
Jeffrey F WilliamsonDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO.
Stephanie MarkovinaDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO.
Julie SchwarzDepartment of Radiation Oncology, Washington University School of Medicine, St. Louis, MO.
Perry W GrigsbyMallinckrodt Institute of Radiology, St. Louis, MO. Electronic address: pgrigsby@wustl.edu.

Funding

Washington University Paul Calabresi K12 Career Development Award for Clinical OncologyK12CA167540 · NCI · WASHINGTON UNIVERSITY · PI John F. Dipersio, Ramaswamy Govindan · 2012 to 2026
$11.7M
Optimizing radiation therapy through the manipulation of glutamine metabolismR01CA181745 · NCI · WASHINGTON UNIVERSITY · PI SCHWARZ, JULIE KRISTINA · 2014 to 2025
$3.4M
RADIOMICS-BASED PROGNOSTIC MODEL OF CERVICAL CANCER HABITATSR21CA223799 · NCI · WASHINGTON UNIVERSITY · PI GRIGSBY, PERRY WAYNE, LI, HUA · 2018 to 2019
$368k
NCI NIH HHS K12 CA167540NCI NIH HHS R01 CA181745NCI NIH HHS R21 CA223799
6 · The paper itself

Abstract

purposeTo compare clinical outcomes between low-dose-rate (LDR) brachytherapy and high-dose-rate (HDR) brachytherapy for cervical cancer patients. METHODS AND MATERIALS: All consecutive newly diagnosed cervical cancer patients undergoing pretreatment 18-fluorodeoxyglucose positron emission tomography imaging and treated with curative-intent definitive chemoradiation from 1997 to 2016 at a U.S. academic center were included. Brachytherapy boost was LDR or HDR 2D treatment planning from 1997 to 2005 and HDR with MR-based 3D planning from 2005 to 2016. Local control (LC), cancer-specific survival (CSS), and late bowel/bladder complications were evaluated.

resultsTumor stages were International Federation of Gynecology and Obstetrics IB1-IIB (n = 457; 75%) and III-IVA (n = 152; 25%). Brachytherapy was LDR for 104 patients and HDR for 505 patients. Concurrent weekly cisplatin was administered to 536 patients (88%). With median followup of 9.4 years, there was no difference in LC (p = 0.24) or CSS (p = 0.50) between LDR and HDR brachytherapy. Cox multivariable regression showed that only International Federation of Gynecology and Obstetrics stage III-IVA (HR=2.4, p = 0.004) was associated with worse LC. A propensity-matched cohort (90 LDR vs. 90 HDR) was created, and the 5-year LC rates were 88% LDR and 82% HDR, p = 0.26; 5-year CSS rates were 66% LDR and 58% HDR, p = 0.19; 5-year grade ≥3 bowel/bladder toxicities were 23% LDR and 16% HDR, p = 0.44. For all patients, the 5-year late toxicity in stage III-IVA patients was higher with LDR 47% vs. HDR 15%, p = 0.03, with no difference in LC, 86% and 75%, respectively (p = 0.09).

conclusionsThere was no difference in LC with either LDR or HDR brachytherapy. The late complication rate was reduced with HDR and 3D-planned brachytherapy compared to LDR and 2D-planned brachytherapy.

Indexed as

AdultAgedAged, 80 and overAntineoplastic AgentsBrachytherapyChemoradiotherapyCisplatinCohort StudiesFemaleFollow-Up StudiesHumansIntestine, LargeMiddle AgedNeoplasm StagingRadiation InjuriesRadiotherapy DosageAntineoplastic AgentsCisplatinBrachytherapyCervical cancerChemoradiationHigh-dose-rateImage-guided adaptive brachytherapyLow-dose-rate

Identifiers

PMID30971370
PMCPMC7477730

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.