Introduction/Background Brachytherapy (BT) lowers the risk of recurrence and improves the survival rates when used after external beam radiotherapy (EBRT), in cervical cancers. In endometrial cancers vaginal cuff BT lowers the risk of vaginal recurrences. New treatment methods have been investigated since BT is not an option for every patient because of the difficulties in placement of BT applicators. Simultaneous integrated boost (SIB) has recently been investigated as an alternative modality in patients BT is not suitable after EBRT.
Methodology Nine patients were treated with the SIB IMRT for cervical and endometrial cancers (table 1)In SIB volume 74 Gy in 2,54 Gy/fraction, in common iliac external-internal iliac and obturator lymph nodes and presacral lymphatic lymph node volumes 50,4 Gy in 1,74 Gy/fractions were administered.(figure 1) In patients with endometrial cancer vagina, paravaginal-parametrial regions received 60 Gy in in 2,3 Gy/fraction with 10 mm margin. 45 Gy in 1,73/fraction was administered to common iliac, external-internal iliac and obturator lymph nodes.
Results All patients with the diagnosis of inoperable cervix carcinoma were in complete remission (CR) The median follow-up was 45 months (18–78 months) with local control (LC) rate of 100%. Acute side effects were seen in 2 patients with cervical carcinoma and in 2 patients with endometrial carcinoma. Late side effects were observed in 1 patient both in cervical and endometrial carcinoma patients (table 2).
Conclusion SIB-IMRT is an alternative treatment option for patients with cervix and endometrial carcinoma. This pioneering study, although contains limited number of patients, presents long term favorable follow up results.
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