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Early clinical outcomes and toxicity of intensity modulated versus conventional pelvic radiation therapy for locally advanced cervix carcinoma : a prospective randomized study . PURPOSE To evaluate the toxicity and clinical outcome in patients with locally advanced cervical cancer ( LACC ) treated with whole pelvic conventional radiation therapy ( WP-CRT ) versus intensity modulated radiation therapy ( WP-IMRT ) . METHODS AND MATERIALS Between January 2010 and January 2012 , 44 patients with International Federation of Gynecology and Obstetrics ( FIGO 2009 ) stage IIB-IIIB squamous cell carcinoma of the cervix were randomized to receive 50.4 Gy in 28 fractions delivered via either WP-CRT or WP-IMRT with concurrent weekly cisplatin 40 mg/m ( 2 ) . Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events , version 3.0 , and late toxicity was graded according to the Radiation Therapy Oncology Group system . The primary and secondary endpoints were acute gastrointestinal toxicity and disease-free survival , respectively . RESULTS Of 44 patients , 22 patients received WP-CRT and 22 received WP-IMRT . In the WP-CRT arm , 13 patients had stage IIB disease and 9 had stage IIIB disease ; in the IMRT arm , 12 patients had stage IIB disease and 10 had stage IIIB disease . The median follow-up time in the WP-CRT arm was 21.7 months ( range , 10.7-37.4 months ) , and in the WP-IMRT arm it was 21.6 months ( range , 7.7-34.4 months ) . At 27 months , disease-free survival was 79.4 % in the WP-CRT group versus 60 % in the WP-IMRT group ( P=.651 ) , and overall survival was 76 % in the WP-CRT group versus 85.7 % in the WP-IMRT group ( P=.645 ) . Patients in the WP-IMRT arm experienced significantly fewer grade ≥2 acute gastrointestinal toxicities ( 31.8 % vs 63.6 % , P=.034 ) and grade ≥3 gastrointestinal toxicities ( 4.5 % vs 27.3 % , P=.047 ) than did patients receiving WP-CRT and had less chronic gastrointestinal toxicity ( 13.6 % vs 50 % , P=.011 ) . CONCLUSION WP-IMRT is associated with significantly less toxicity compared with WP-CRT and has a comparable clinical outcome . Further studies with larger sample sizes and longer follow-up times are warranted to justify its use in routine clinical practice .
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Intervention_Pharmacological
whole pelvic conventional radiation therapy
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Intervention_Pharmacological
intensity modulated radiation therapy
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Intervention_Physical
WP-CRT
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Intervention_Physical
WP-IMRT
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Intervention_Pharmacological
WP-CRT
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Intervention_Pharmacological
WP-IMRT
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Intervention_Pharmacological
WP-CRT
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Intervention_Pharmacological
IMRT
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Intervention_Pharmacological
WP-CRT
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Intervention_Pharmacological
WP-IMRT
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Outcome_Physical
toxicity
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Outcome_Physical
clinical outcome
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Outcome_Adverse-effects
Acute toxicity
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Outcome_Adverse-effects
Common Terminology Criteria for Adverse Events , version 3.0 , and late toxicity
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Outcome_Adverse-effects
acute gastrointestinal toxicity
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Outcome_Mortality
disease-free survival
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Outcome_Mortality
disease-free survival
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Outcome_Mortality
overall survival
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Participant_Condition
locally advanced cervix carcinoma :
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Participant_Condition
patients with locally advanced cervical cancer ( LACC )