Tumor shrinkage before intracavitary brachytherapy for cancer of the cervix: Radiotherapy alone versus concurrent chemoradiotherapy

PURPOSE The purpose of this study was to compare the tumor shrinkage between radiot herapy alone and concurrent chemoradiotherapy before intracavitary brachyth erapy (ICBT). MATERIALS AND METHODS Nineteen consecutive patients (three stage IB2, nine stage IIB, seven stage IIIB) were selected for measurement of tumor regression. Ten patients unde rwent radiotherapy alone, and nine patients underwent concurrent cisplatin- based chemoradiotherapy. The average dose of pelvic radiation was given at 45 Gy over a 5-week period in both groups. Computed tomography-based tumor measurement before treatment was compared with measure ment after treatment but before intracavitary brachytherapy. The largest width and thickness of the cervical mass were measured from the axial computed tomographic images . RESULTS Tumor regression before intracavitary brachytherapy varied widely, ranging from 15% to 65%. However, the tumor regression in patients who underwent ch emoradiotherapy was higher, ranging from 41% to 65% (mean, 55%), compared w ith radiotherapy alone, which ranged from 15% to 52% (mean, 38%). CONCLUSION Our results show that significant tumor shrinkage occurs with concurrent ch emoradiotherapy compared with radiotherapy alone. This finding supports the results of recent clinical trials demonstrating improvement of pelvic cont rol and survival with concurrent chemoradiotherapy for advanced cancer of t he cervix.