Yonsei Med J.  2002 Dec;43(6):737-748. 10.3349/ymj.2002.43.6.737.

Fractionated High-Dose-Rate Brachytherapy in the Management of Uterine Cervical Cancer

• Park HC
• Suh CO
• Kim GE

• KMID: 1093949
• DOI: http://doi.org/10.3349/ymj.2002.43.6.737

Abstract

It is well known that intracavitary radiotherapy (ICR), either alone or in combination with external-beam radiotherapy (EBRT) is an essential component of the radiation treatment of uterine cervical cancer. Although low-dose-rate (LDR) brachytherapy has been successfully applied to the management of such patients, several radiation oncologists have experience of using high-dose-rate (HDR) brachytherapy with promising clinical results over the past 4 decades. However, there has been a considerable reluctance by radiation oncologists and gynecologists in North America to employ the HDR remote afterloading technique instead of the more firmly established LDR treatment modality. In contrast, the HDR-ICR system is rapidly gaining acceptance in Korea since the introduction of the Ralstron, remotely controlled afterloading system using HDR Co-60 sources, at the Yonsei Cancer Center in 1979. According to brachytherapy statistics reported by the Korean Society of Therapeutic Radiology and Oncology, in 1997, brachytherapy was performed upon 1,758 Korean patients with uterine cervical cancer, of whom approximately 83% received HDR brachytherapy. In this review, we present our experiences of HDR-ICR for the treatment of uterine cervical cancer. In addition, we discuss the controversial points, which are raised by those considering the use of HDR-ICR for uterine cervical cancer; these issues include physical and radiobiological considerations, and the prospect of future technical improvements.

Keyword

Cervical cancer; radiotherapy; high-dose-rate; brachytherapy

MeSH Terms

Brachytherapy/*methods
Cervix Neoplasms/*radiotherapy
Dose Fractionation
Female
Human
Radiotherapy Planning, Computer-Assisted