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High-dose-rate intracavitary radiotherapy in the management of cervical intraepithelial neoplasia 3 and carcinoma in situ presenting with poor histologic factors after undergoing excisional procedures.

Authors
 Yong Bae Kim  ;  Young Tae Kim  ;  Nam Hoon Cho  ;  Woong Sub Koom  ;  Sunghoon Kim  ;  Sang Wun Kim  ;  Eun Ji Nam  ;  Gwi Eon Kim 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.84(1) : 19-22, 2012 
Journal Title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
ISSN
 0360-3016 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Brachytherapy/methods* ; Carcinoma in Situ/mortality ; Carcinoma in Situ/pathology ; Carcinoma in Situ/radiotherapy* ; Carcinoma in Situ/surgery ; Cervical Intraepithelial Neoplasia/mortality ; Cervical Intraepithelial Neoplasia/pathology ; Cervical Intraepithelial Neoplasia/radiotherapy* ; Cervical Intraepithelial Neoplasia/surgery ; Cervix Uteri/pathology ; Cobalt Radioisotopes/therapeutic use ; Disease-Free Survival ; Female ; Humans ; Iridium Radioisotopes/therapeutic use ; Middle Aged ; Neoplasm, Residual ; Postoperative Care ; Radiotherapy Dosage ; Retrospective Studies ; Uterine Cervical Neoplasms/mortality ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/radiotherapy* ; Uterine Cervical Neoplasms/surgery
Keywords
Adult ; Aged ; Aged, 80 and over ; Brachytherapy/methods* ; Carcinoma in Situ/mortality ; Carcinoma in Situ/pathology ; Carcinoma in Situ/radiotherapy* ; Carcinoma in Situ/surgery ; Cervical Intraepithelial Neoplasia/mortality ; Cervical Intraepithelial Neoplasia/pathology ; Cervical Intraepithelial Neoplasia/radiotherapy* ; Cervical Intraepithelial Neoplasia/surgery ; Cervix Uteri/pathology ; Cobalt Radioisotopes/therapeutic use ; Disease-Free Survival ; Female ; Humans ; Iridium Radioisotopes/therapeutic use ; Middle Aged ; Neoplasm, Residual ; Postoperative Care ; Radiotherapy Dosage ; Retrospective Studies ; Uterine Cervical Neoplasms/mortality ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/radiotherapy* ; Uterine Cervical Neoplasms/surgery
Abstract
PURPOSE: To assess the effectiveness of high-dose-rate intracavitary radiotherapy (HDR-ICR) in patients with cervical intraepithelial neoplasia 3 (CIN 3) and carcinoma in situ (CIS) presenting with poor histologic factors for predicting residual disease after undergoing diagnostic excisional procedures. METHODS AND MATERIALS: This study was a retrospective analysis of 166 patients with CIN 3 (n=15) and CIS (n=151) between October 1986 and December 2005. They were diagnosed by conization (n=158) and punch biopsy (n=8). Pathologic analysis showed 135 cases of endocervical gland involvement (81.4%), 74 cases of positive resection margins (44.5%), and 52 cases of malignant cells on endocervical curettage (31.3%). All patients were treated with HDR-ICR using Co⁶⁰ or Ir¹⁹² at a cancer center. The dose was prescribed at point A located 2 cm superior to the external os and 2 cm lateral to the axis of the tandem for intact uterus. RESULTS: Median age was 61 years (range, 29-77). The median total dose of HDR-ICR was 30 Gy/6 fractions (range, 30-52). At follow-up (median, 152 months), 2 patients developed recurrent diseases: 1 CIN 2 and 1 invasive carcinoma. One hundred and forty patients survived and 26 patients died, owing to nonmalignant intercurrent disease. Rectal bleeding occurred in one patient; however, this symptom subsided with conservative management. CONCLUSIONS: Our data showed HDR-ICR is an effective modality for CIN 3 and CIS patients presenting with poor histologic factors after excisional procedures. HDR-ICR should be considered as a definitive treatment in CIN 3 and CIS patients with possible residual disease after undergoing excisional procedures.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301612003112
DOI
22901420
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Gwi Eon(김귀언)
Kim, Sang Wun(김상운) ORCID logo https://orcid.org/0000-0002-8342-8701
Kim, Sung Hoon(김성훈) ORCID logo https://orcid.org/0000-0002-1645-7473
Kim, Young Tae(김영태) ORCID logo https://orcid.org/0000-0002-7347-1052
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Nam, Eun Ji(남은지) ORCID logo https://orcid.org/0000-0003-0189-3560
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90540
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