ArticleReports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology2025
Comparative study of dosimetry and treatment outcome of two different dose fractionation schedules of high dose rate intracavitary brachytherapy in locally advanced cancer cervix.
Article in Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Optimizing high dose rate intracavitary brachytherapy (HDR-ICBT) fractionation regimens remains elusive due to concerns about radiation toxicity, despite varied schedules being used across centers for decades. This study investigates the effectiveness of two different HDR brachytherapy schedules for treating cervical cancer, comparing their outcomes in terms of acute toxicities and local control. Materials and methods: 100 cervical carcinoma patients (stage IB3 to IVA, excluding IIIC2) were randomized into 2 arms and treated by concurrent chemo-radiotherapy followed by HDR brachytherapy, comparing 7 Gy per fraction per week for 3 fractions (Arm A) Results: The two fractionation schedules demonstrated similar efficacy for loco-regional control. While the mean equivalent dose at the bladder, sigmoid and bowel was higher in Arm B as compared to Arm A, the difference was statistically insignificant (p > 0.05). In contrast, the mean equivalent dose at the rectum was lower in Arm B as compared to Arm A but again statistically insignificant (p > 0.05). However, acute gastrointestinal toxicity (Grade 2 and 3) was found significantly lower (p < 0.001) in Arm B (46.0%) as compared to Arm A. Conclusion: Both HDR brachytherapy schedules showed comparable efficacy with no significant difference in local control, but 6Gy per fraction for 4 fractions (Arm B) had a better toxicity profile and higher biologically equivalent dose, although long-term follow-up is needed to assess late toxicities.
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