Whole pelvis megavoltage irradiation with single doses of 1000 rad to palliate advanced gynecologic cancers

Palliation of Pelvic and Head and Neck Cancer with Paclitaxel and a Novel Radiotherapy Regimen

“…1 This schedule produced significant palliation in this group of patients with symptomatic improvement in approximately 50% of patients and objective tumor regression in 35%-80%. It initially suggested a low incidence of side effects.…”

Palliative pelvic radiotherapy for gynaecologic cancer

“…Boulware et al [15] reported relief of obstructive uropathy (as demonstrated by intravenous pyleography), with improvement in edema/uremia as the reported outcome in 24 %, 75 %, and 75 % of patients receiving 1, 2, and 3 fractions of pelvic RT, respectively. This correlated with increasing rates of objective tumour response, suggesting a correlation with tumour shrinkage.…”

“…The duration of pain relief was also difficult to assess with the retrospective nature of the studies and patients being lost to follow-up. Boulware et al [15] found complete or partial pain relief in 45 % of patients after a single 10 Gy, 59 % improvement after two fractions, and 63 % improvement after three fractions. Hodson and Krepart [16] reported pain relief in six patients, but the number of patients with pain at baseline was not given.…”

“…Starting with Boulware et al's [15] report in 1979, the MD Anderson experience of three monthly fractions of 10 Gy to the whole pelvis, other centres have subsequently reported their experience using this dose/fraction. The specific indications for repeating the second and third fractions are variable and not always reported, but generally include having a response to treatment and remaining in satisfactory performance status.…”

High dose rate (HDR) cervical ring applicator to control bleeding from cervical carcinoma

“…Instead, the patients showing hemostasis after the first fraction should have been treated subsequently by external beam radiation therapy (EBRT) in the same manner as after the second fraction of HDR brachytherapy. EBRT is also a proven modality for effective control of hemorrhagic cervical cancer (2)(3)(4) . Though earlier reports (2,3) have used higher dose per fraction (up to 10 Gy per fraction), currently conventional fractionation (4) is preferred due to equal efficacy and lesser radiation morbidity associated with it.…”