Downloads: 0 | Views: 51
Doctoral Thesis | Radiotherapy & Oncology | India | Volume 12 Issue 12, December 2023 | Rating: 4.7 / 10
Comparison of Local Disease Control and Toxicities in Two High Dose Rate Intracavitatory Brachytherapy Dose Fractionation Regimens (7Gy/3# v/s 9Gy/2#) in the Radical Treatment of Carcinoma Cervix: a Prospective Randomized Trial in Sub-Himalayan Region
Abstract: Background: Cervical carcinoma is the most prevalent gynecological cancer. Majority of patients in sub-himalayan region presents in locally advanced stage in which chemoradiotherapy followed by intracavitatory brachytherapy is the main line of treatment. ICBT plays an integral part of the treatment but there is no consensus guideline about an optimal fractionation regimen. In a resource limited setting with increased patient load, there is a need to reduce ICBT sessions with simultaneous increase in dose per fraction. We performed a RCT comparing local disease control and toxicities between two different dose regimens of ICBT i.e., 7Gy per fraction in 3# and 9Gy per fraction in 2# in sub-himalayan region. Methods: The prospective study was undertaken in 59 patients of ca cervix from stage IB3 to IVA from May 2020 to May 2021 at Department of Radiotherapy and Oncology, Tertiary Cancer Centre, Indira Gandhi Medical College Shimla (H.P.). All patients were treated initially with external beam radiotherapy of 50Gy/25# by four field technique combined with weekly injection cisplatin (dose 40mg/m2). Study group had 28 patients who received 2 fractions of ICBT of 9Gy each whereas 31 patients in control group received 3 fractions of ICBT of 7Gy each. Local response and rectal as well as genitourinary toxicities were assessed after 4 months of treatment completion. Results: Patients in both the arms had equivalent local response with 60% complete response in study arm and 83.9% complete response in control arm. The difference in local response was not statistically significant (p=0.08). Similarly, GIT and GUT toxicities were comparable in both the arms with only 1 patient in control arm developing grade III GIT toxicity. None of the patients developed grade IV GIT/GUT toxicities. Conclusion: The results show that 9Gy/2# ICBT schedule is as effective and safe option as 7Gy/3# with similar local control and manageable GIT and GUT toxicities, making it a practical alternative in a resource-limited setting.
Keywords: Carcinoma cervix, ICBT dose regimen, 9Gy/2# v/s 7Gy/3#, GIT/ GUT toxicities
Edition: Volume 12 Issue 12, December 2023,
Pages: 516 - 518