16 Cervix Carcinoma

Cervix Cancer 353

Table 14.4: Results of definitive radiotherapy in extended disease

Authors

N° pts

Stage

5-yr survival (%)

5-y Local control (%)

Manchester

1993

50

III

34 OS

LDR Hunter 2001 (62)

Perez LDR

(86)

293 20

III IV

52 DFS 0 44 OS 60 OS 36 DSS

59 25 67 84 78

Houston MDAH (26, 28) Fletcher LDR (73) French cooperative group LDR (53)

73 a* 25 b* 983

IB 2

IIB (bulk)

IIIB (UICC) IIIA MDAH IIIB MDAH IV Distal II IIIA-B, IV

266 216 32 58 416 60 107 106

61 OS (62) 39 OS (50) 20 OS

68 (63) 45 (57) 18

Paris LDR

IGR

(42)

65 OS 42 OS 70 OS 42 OS 38 OS

78 66 77 54 56

Pernot

(92)

Distal IIB III

LDR

Joslin (64, 65) HDR

III

Petereit

(93)

50

IIIB

33 OS

44

HDR

Vienna HDR Pötter (96) 65 48 *In the analysis by Eifel et al. (26) patients were grouped according to the total dose applied in terms of radium mg.h (>/<= 6000) or dose to point A: a: >/=85 Gy (mean 89); b: < 85 Gy. The increasing use of HDR brachytherapy has been controversial for decades (compare 25). Few results, which can be taken as comparable to LDR and which may be representative, have been listed in tables 4 and 5 (64,65,93,96,105; for a retrospective comparative overview see 82; for a comparison of dose and fractionation see 94 and 108). The results of a few prospective comparative trials between LDR and HDR brachytherapy are presented here (Table 6). These trials did not always meet the current criteria for a prospective controlled comparative evaluation of different treatments. Therefore, the results shown in the table must be interpreted with much caution. 78 12 IIIB IVA 48 DSS 19 DSS