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High-dose-rate versus low-dose-rate intracavitary brachytherapy for carcinoma of the cervix

https://doi.org/10.1016/0360-3016(90)90511-HGet rights and content

Abstract

High-dose-rate (HDR) remote afterloading intracavitary brachytherapy has been widely used in the treatment of carcinoma of the cervix in Europe and Asia since the 1960's. Recently, there has been an increase of interest in the use of this technique in North America. Most of the non-randomized studies suggest similar survival, local control, and complication rates using fractionated high-dose-rate remote afterloading intracavitary brachytherapy combined with external beam irradiation compared to historical or concurrent low-dose-rate (LDR) controls. However, the techniques as well as the dose fractionation schedules used in different institutions are variable. The optimal technique and dose fractionation scheme has yet to be established through systematic clinical trials.

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      Brachytherapy is an important component in the curative management of carcinoma of the cervix, and significantly improves survival (1, 2). High-dose-rate (HDR) and low-dose-rate (LDR) brachytherapy seem to be relatively equivalent treatments in terms of survival outcomes based on existing retrospective and prospective studies (3–11). Advantages of HDR brachytherapy include opportunities for outpatient treatment, avoidance of exposure to staff from the radiation source, consistent and reproducible applicator positioning, and dose optimization attained with a variable dwell-time stepping source (3).

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    Presented at the 30th annual meeting of the American Society of Therapeutic Radiology and Oncology, 9–14 October 1988, New Orleans, LA.

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