Results of high dose rate brachytherapy, anterior pelvic exenteration and external beam radiotherapy for carcinoma of the female urethra

Purpose: We evaluated a multimodality approach to locally advanced urethral carcinoma in women. Materials and Methods: Between August 1996 and July 1999, 6 women were trea ted for locally advanced carcinoma of the urethra with anterior pelvic exen teration followed by high dose (192)iridium intraoperative radiation therap y. Four of the 6 patients were also treated with neoadjuvant or concomitant platinum based chemotherapy. Results: Two patients had no evidence of disease, 3 had distant metastasis and 2 had local recurrence at a mean followup of 21 months (range 12 to 47) . Radiation was relatively well tolerated with no major adverse events. Conclusions: High dose intraoperative brachytherapy followed by external be am radiation is relatively well tolerated. Local control seems to have impr oved. We must evaluate a larger cohort of patients to determine this impact of the combined modality on local control and patient survival.