Acute problems during low-dose-rate intracavitary brachytherapy for cervical carcinoma

Objective. To estimate the incidence and severity of problems arising durin g the hospitalization of cervical carcinoma patients undergoing low-dose-ra te intracavitary brachytherapy (ICB). Methods. One hundred seventy ICE implants in 128 cervical carcinoma patient s undergoing curative radiation therapy were reviewed. All events during th e hospitalization requiring physician evaluation and/or intervention were s cored as a "problem" and divided into 10 categories (fever/infection, pain, gastrointestinal, renal, pulmonary, cardiac, dermatologic, gynecologic, en docrinologic, psychiatric). Problems were scored as mild (no significant mo rbidity, therapy not discontinued), moderate (therapy discontinued but no s ignificant morbidity), or severe (significant morbidity or mortality). Pati ent and treatment factors were correlated with acute problems. Results. Forty-two implants (24.7%) were associated with acute problems (95 % minor, 5% moderate, 0% severe). The most common types were fever/infectio n (14.1%) and gastrointestinal problems (5.9%). Other problem types occurre d in <3% of implants. No patient or treatment factor including age, comorbi d disease, weight, implant duration, or anesthesia type was significantly c orrelated with acute problems. Patients who developed acute problems had a survival (P = 0.21) and risk of late sequelae (P = 0.74) similar to those o f patients without acute problems. Conclusion. Problems occur during the hospitalization in approximately one- quarter of cervical carcinoma patients undergoing low-dose-rate ICE. Howeve r, most are minor and do not result in morbidity, require discontinuation o f therapy, or adversely impact on outcome. (C) 2000 Academic Press.