PURPOSE: To evaluate factors affecting survival and toxicity in patients with stage IIIB cervical cancer treated with external-beam radiotherapy and low-dose-rate brachytherapy. MATERIALS AND METHODS: Seventy patients with stage IIIB cervical cancer treated between 1980 and 2000 were identified. A total of 51 patients had a tandem placed; 19 had interstitial brachytherapy only with no tandem placed. Univariate and multivariate analyses assessed factors potentially associated with survival and long-term complications. RESULTS: Kaplan-Meier estimates for overall survival (OS) for the entire population at 2, 3, and 4 years were 43%, 29%, and 27%, respectively. Overall survival differed significantly between those treated with a tandem versus those treated without (log rank P < 0.0001). Significant predictors of OS on univariate Cox regression were presence of a tandem (hazards ratio [HR], 0.31; P = 0.0001) and cumulative dose to point A (HR, 0.95; P = 0.0001). Multivariate regression showed that the presence of a tandem was the only significant predictor of OS (HR, 0.46; P = 0.04). There were no significant predictors of complications. CONCLUSIONS: The dose to point A of approximately 85 Gy as associated with tandem use was a significant predictor of survival in patients with stage IIIB cervical carcinoma, indicating the significance of the central location of the high dose provided by the tandem. Patients selected for interstitial brachytherapy alone must receive sufficient dose, and a tandem should be placed whenever feasible for all patients with an intact uterus treated for locally advanced cervical cancer.
PURPOSE: To evaluate factors affecting survival and toxicity in patients with stage IIIB cervical cancer treated with external-beam radiotherapy and low-dose-rate brachytherapy. MATERIALS AND METHODS: Seventy patients with stage IIIB cervical cancer treated between 1980 and 2000 were identified. A total of 51 patients had a tandem placed; 19 had interstitial brachytherapy only with no tandem placed. Univariate and multivariate analyses assessed factors potentially associated with survival and long-term complications. RESULTS: Kaplan-Meier estimates for overall survival (OS) for the entire population at 2, 3, and 4 years were 43%, 29%, and 27%, respectively. Overall survival differed significantly between those treated with a tandem versus those treated without (log rank P < 0.0001). Significant predictors of OS on univariate Cox regression were presence of a tandem (hazards ratio [HR], 0.31; P = 0.0001) and cumulative dose to point A (HR, 0.95; P = 0.0001). Multivariate regression showed that the presence of a tandem was the only significant predictor of OS (HR, 0.46; P = 0.04). There were no significant predictors of complications. CONCLUSIONS: The dose to point A of approximately 85 Gy as associated with tandem use was a significant predictor of survival in patients with stage IIIB cervical carcinoma, indicating the significance of the central location of the high dose provided by the tandem. Patients selected for interstitial brachytherapy alone must receive sufficient dose, and a tandem should be placed whenever feasible for all patients with an intact uterus treated for locally advanced cervical cancer.
Authors: Akila N Viswanathan; Jennifer Moughan; William Small; Charles Levenback; Revathy Iyer; Sharon Hymes; Adam P Dicker; Brigitte Miller; Beth Erickson; David K Gaffney Journal: Int J Gynecol Cancer Date: 2012-01 Impact factor: 3.437
Authors: Akila N Viswanathan; Beth Erickson; David K Gaffney; Sushil Beriwal; Sudershan K Bhatia; Omer Lee Burnett; David P D'Souza; Nikhilesh Patil; Michael G Haddock; Anuja Jhingran; Ellen L Jones; Charles A Kunos; Larissa J Lee; Lilie L Lin; Nina A Mayr; Ivy Petersen; Primoz Petric; Lorraine Portelance; William Small; Jonathan B Strauss; Kanokpis Townamchai; Aaron H Wolfson; Catheryn M Yashar; Walter Bosch Journal: Int J Radiat Oncol Biol Phys Date: 2014-10-01 Impact factor: 7.038
Authors: Akbar Alipour; Akila N Viswanathan; Ronald D Watkins; Hassan Elahi; Wolfgang Loew; Eric Meyer; Marc Morcos; Henry R Halperin; Ehud J Schmidt Journal: Med Phys Date: 2021-10-08 Impact factor: 4.071
Authors: Leila T Tchelebi; Biyi Shen; Ming Wang; Louis Potters; Joseph Herman; Daniel Boffa; Joel E Segel; Henry S Park; Nicholas G Zaorsky Journal: Adv Radiat Oncol Date: 2022-03-08
Authors: Matthew M Harkenrider; Steven M Shea; Abbie M Wood; Bonnie Chinsky; Amishi Bajaj; Michael Mysz; Joseph H Yacoub; Ari Goldberg; Margaret Liotta; Ronald Potkul; Murat Surucu; John Roeske; William Small Journal: J Contemp Brachytherapy Date: 2017-03-30