A PROSPECTIVE STUDY TO SEE THE FEASIBILITY, TOXICITY AND EFFICACY OF TWICE WEEKLY INTERDIGITATED, INTRACAVITARY HIGH DOSE RATE BRACHYTHERAPY IN PATIENTS OF LOCALLY ADVANCED CARCINOMA CERVIX UNDERGOING CONCURRENT CHEMORADIATION

Dr.Pritam Kr Sardar, Dr. Lekshmi R Shenoi, Prof (Dr) Siddharta Basu

Abstract


INTRODUCTION: Due to accelerated repopulation, the treatment of inoperable locally advanced Cervical carcinoma(LACC)  should be completed within 8 weeks.In this study, we aim to further reduce the treatment time by interdigitating brachytherapy with CCRT.

AIMS AND OBJECTIVES:To assess the response according to RECIST criteria, version 1.1 and acute toxicities according to the Radiation Therapy Oncology Group [RTOG] criteria.

MATERIALS AND METHODS:After undergoing metastatic work up, patients with histologically proved  LACC were treated with CCRT.After 17 fractions eligible patients received HDR brachytherapy twice weekly with a dose of 7Gy/fraction in 4 fractions.No radiation or chemotherapy were given on brachytherapy days.During treatment, patients were reviewed weekly clinically and with blood reports and thereafter 6 weekly for 3 months and 3 monthly till the end of the study.

RESULTS:Most common toxicity encountered during study was GI toxicty (81.1%) followed by haematological toxicity(48.6%) and skin toxicity(21.6%).Most grave toxicity was proctitis which was seen in 6 patients(16.2%).In this study overall response rate at 6 weeks after treatment completion(complete response and partial response) was 100% with complete response(86.5%) and partial response(13.5%).The median duration of follow-up after initial 6 weeks post-treatment assessment was 6 months.


Keywords


Interdigitate brachytherapy ,toxicity, locally advanced cervical cancer,CCRT.

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References


Aswathy Sreedevi et al(2015)Epidemiology of cervical cancer with special focus on India, Int J Womens Health. Vol 7: pp 405–414.

Perez&Brady(2018),Principles and Practice of Radiation Oncology, 7th edition, Wolter Kluwer, Philadelphia.

Lodha M.et al(2011),The effect of shortening of overall treatment time on local control, disease free survival & toxicity by interdigitating HDR intracavitary brachytherapy with concurrent chemoradiation in carcinoma cervix.International Journal of Gynecological Cancer. Conference Start: 20110402 Conference End: 20110403. Conference Publication: (var.pagings). 21 (11 SUPPL. 2) (pp 54).

Nawed Alam et al(2010) Interdigitated versus sequential high dose rate intracavitary brachytherapy with external beam radiotherapy in locally advanced carcinoma cervix,DOI:10/4103/jcrt. JCRT_301_17.

Abhishek Basu et al(2018),Concurrent chemoradiation with sequential versus interdigitated brachytherapy for locally advanced carcinoma cervix an open label randomised clinical trial,international journal of scientific research.vol-7.

Akila N. Viswanathan et al(2012),The American Brachytherapy Society Treatment Recommendations for Locally Advanced Carcinoma of the Cervix Part II: High Dose-Rate Brachytherapy 11(1): 47–52. doi: 10.1016/j.brachy.2011.07.002 .


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