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DOI http://dx.doi.org/10.1016/S0360-3016(97)00924-3
Title High-dose-rate intracavitary brachytherapy in the management of cervical and vaginal intraepithelial neoplasia
Creator/Author Ogino, Ichiro ; Kitamura, Tatsuo ; Okajima, Hiroyuki ; Matsubara, Sho
Publication Date1998 Mar 01
OSTI IdentifierOSTI ID: 20428812
Other Number(s)ISSN 0360-3016; IOBPD3 ; TRN: US03R4232011403
Resource TypeJournal Article
Resource RelationInternational Journal of Radiation Oncology, Biology and Physics ; VOL. 40 ; ISSUE: 4 ; PII: S0360301697009243; Copyright (c) 1998 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); PBD: 1 Mar 1998
Subject62 RADIOLOGY AND NUCLEAR MEDICINE ; CAVITIES; DOSE RATES; EPITHELIUM; MENOPAUSE; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; UROGENITAL SYSTEM DISEASES; UTERUS
Description/Abstract Purpose: To assess the effectiveness of high-dose rate intracavitary brachytherapy (HDR-ICR) in patients with grade 3 cervical intraepithelial neoplasia (CIN-3) and grade 3 vaginal intraepithelial neoplasia (VAIN-3). Methods and Materials: This was a retrospective analysis in 20 patients with CIN-3 (n= 14) or VAIN-3 (n= 6), average age 61.9 years, managed with HDR-ICR at Kanagawa Cancer Center. Two patients with CIN-3 with microinvasive foci and 11 other patients with CIN-3 were treated with HDR-ICR for cervical lesions. Six patients with CIN-3 after hysterectomy received HDR-ICR for recurrent or residual VAIN-3 lesions. One patient received radiation therapy for both CIN-3 and VAIN-3 lesions. All these patients but one were postmenopausal. Results: Seventeen patients were treated with HDR-ICR alone, and three with combined external radiation therapy. The dose was calculated at Point A located 2 cm superior to the external os and 2 cm lateral to the axis of the intrauterine tube for intact uterus. For lesions of the vaginal stump, the dose was calculated at a point 1 cm superior to the vaginal apex or 1 cm beyond vaginal mucosa. In the 14 patients treated for CIN-3 lesions, the mean total dose of HDR-ICR was 26.1 Gy (range 20-30). Six patients received HDR-ICR for VAIN-3 lesions with mean dose of 23.3 Gy (range 15-30). At follow-up (mean 90.5 months; range 13-153), 14 patients were alive and 6 had died owing to nonmalignant intercurrent disease. No patient developed recurrent disease. Rectal bleeding occurred in three patients, but this symptom subsided spontaneously. Moderate and severe vaginal reactions were noted in two patients, in whom the treatment had included the entire vagina. Conclusions: HDR-ICR can be employed as the primary management strategy for postmenopausal women with CIN-3. In intraepithelial neoplasia involving the vaginal wall after hysterectomy, HDR-ICR should be considered as an alternative to total vaginectomy.
Country of PublicationUnited States
LanguageEnglish
Formatpage(s) 881-887
System Entry Date2004 Feb 23

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