1003 / 1778
Studies comparing different dose levels
•
Higher dose + including whole length increased severe
morbidity and shortening of the vagina
•
Osrund: individualized prescription 0.3 – 0.4 – 0.5 cm less grade
1-2 vaginal morbidity
Author (ref)
acrual period
No. patients, eligibility
Treatment
Vaginal
recurrence
Locoregional
recurrence
Survival
Severe complications
Kloetzer et al.
30
108; Stage I-II
4 x 10 Gy at 0.5 cm 0,0% 2,2% 98% OS at 3-years 2.2% / 0.0% grade 3/4
1981-1990
4 x 10 Gy at 1 cm
3,1% 3,1% 97% OS at 3-years 6.2% / 3.1% grade 3/4
4 x 10 Gy at 1 cm + vagina 0,0% 0,0% 97% OS at 3-years 6.8% / 12.6% grade 3/4
Osrund et al.
37
217; Stage I-II
4 x 5.5 Gy at 0.5 cm 1,0%
26% / 8% grade 1/2
1988-1996
4 x 5.5 Gy individualized 2,5%
17% / 1% grade 1/2
at 0.3-0.4-0.5 cm
no grade 3/4
Sorbe et al.
34
290; Stage IA grd 1-2 6 x 2.5 Gy at 0.5 cm vs.
0,7% 1,4% 95% OS at 5-years vaginal shortening
1989-2003
6 x 5.0 Gy at 0.5 cm
0.3 cm vs. 2.1 cm
Studies with different brachytherapy dose levels