Anna Harris, Presenter: Nothing to Disclose

Tony Y. Eng MD, Abstract Co-Author: Nothing to Disclose

Abhilasha J Patel MD, Abstract Co-Author: Nothing to Disclose

Michael James Crotty MD, Abstract Co-Author: Nothing to Disclose

Virginia Clyburn MD , Abstract Co-Author: Nothing to Disclose

Purpose/Objective(s): To determine the impact of OTD on the local control of carcinoma of the uterine cervix treated with HDR-ICBT.The influence of OTD on outcome for squamous cell cancer of the uterine cervix treated with low-dose-rate intracavitary brachytherapy (LDR-ICBT) has been well addressed in literature. While most institutions have switched over to HDR-ICBT, which often are delivered in multiple sessions once or twice a week during or after external beam radiation therapy that may lead to prolongation of overall treatment time, the effect of OTD on local control for those treated with HDR-ICBT has not been well established.Materials/Methods: Between Jan 2006 and December 2009, 93 patients with FIGO stage IB1-IVB carcinoma of the cervix were treated with platinum-based systemic chemotherapy concurrently with pelvic external beam radiotherapy (45-50.4 Gy), and HDR-ICBT (Nucletron tandem and ovoids). Eighteen patients were excluded because of lost to follow-up, non-squamous cell histology, or inadequate information. The remaining 75 patients formed the basis of this study. HDR-ICBT was delivered in 4 to 7 sessions, twice per week, 300 cGy to 700 cGy per session prescribed to point A, and typically 5 to 7 days between completion of pelvic radiation and start of HDR-ICBT. The mean OTD was 66 days (55-153 days).Results: At a mean follow up of 22 months (1-52 months), there were 8 (11%) local recurrences (LR). Six of these patients had Stage IIIB disease. The mean OTD of this group was 66 days. Patients with OTD > 63 days did not demonstrate a higher LR rate than those with OTD < 63 days (see table below). There were 21 patients who developed regional and/or distant metastsis (RDM), of which, 1 was Stage IB2, 4 Stage IIB, 13 Stage IIIB, and 2 Stage IVB. We did not observe a statistically significant correlation between OTD and RDM. Thus far, there appears to be no difference in overall survival (OS).Conclusions: Slight prolongation of OTD does not appear to affect the local control of carcinoma of the uterine cervix treated with HDR-ICBT as we did not observe a statistically significant impact of OTD when > 63 days. LR was strongly correlated with stage at presentation. However, this is a retrospective study with a relatively small number of patients with short follow up.

Harris, A, Eng, T, Patel, A, Crotty, M, Clyburn, V, The Impact of Overall Treatment Duration (OTD) on the Local Control of Carcinoma of the Uterine Cervix Treated with High-Dose-Rate Intracavitary Brachytherapy (HDR-ICBT).  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11030534.html