Better technology but similar outcomes: Lessons from the University of Florida experience with primary radiotherapy for early-stage cervix cancer

Objective: To determine if the use of more complex technology in the form of 3-dimensional treatment planning improved outcomes after primary radiotherapy for early-stage cervical cancer. Methods: 180 Consecutive cases treated with primary radiotherapy from 1980 to 2005 for stage IB to IIB cancer of the cervix were reviewed. In 1996, we increased the cost and complexity of the planning process by changing from 2-dimensional to 3-dimensional treatment planning. The purpose of this project was to test the hypothesis that such change in treatment planning improved patient outcome. Results: 3-Dimensional planning was not associated with better outcomes as measured by relapse-free survival or grade 3-5 toxicity. Conclusion: At our institution, converting to 3-dimensional radiotherapy planning for cervix cancer increased the cost and complexity of treatment without improving outcomes. This observation has important implications for the implementation of new technologies beyond settings where efficacy has been clearly demonstrated.