Para-aortic and pelvic extended-field radiotherapy for XXXX : dosimetric and toxicity comparison between the four-field box and intensity-modulated techniques.

@entity1 @entity1204 @entity5 @entity344 @entity2335
BACKGROUND: In @entity1 with advanced-stage @entity1204 ( @entity1204 ), extended-field radiotherapy (efrt) is traditionally delivered by the 3-dimensional conformal (3d-crt) 4-field box technique. In recent years, the use of intensity-modulated radiotherapy (imrt) in gynecologic @entity5 has increased. We compared the delivery of efrt by the 3d-crt and contemporary imrt techniques. METHODS: After surgical staging and adjuvant chemotherapy in 38 @entity1204 @entity1 , efrt was delivered by either imrt or 3d-crt. Doses to the organs at risk, side effects, and outcomes were compared between the techniques. RESULTS: Of the 38 @entity1204 @entity1 , 33 were stage iiic, and 5 were stage ivb. In the imrt group, maximal doses to rectum, small intestine, and bladder were significantly higher, and mean dose to bladder was lower (p < 0.0001). Most acute gastrointestinal, genitourinary, and hematologic side effects were grade i or ii and were comparable between the groups. In long-term follow-up, only grade 1 @entity2335 at 3 months was statistically higher in the imrt @entity1 . No grade iii or iv @entity344 were observed. No statistically significant differences in overall and disease-free survival or recurrence rates were observed between the techniques. CONCLUSIONS: In advanced @entity1204 @entity1 , imrt is a safe and effective technique for delivering efrt to the pelvis and para-aortic region, and it is comparable to the 3d-crt 4-field box technique in both side effects and efficacy. For centres in which imrt is not readily available, 3d-crt is a valid alternative.
