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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