Assessing Feasibilities and Toxicities of Introducing Intracavitary Brachytherapy Early during EBRT in Cervical Cancer

Kavithendral, K (2020) Assessing Feasibilities and Toxicities of Introducing Intracavitary Brachytherapy Early during EBRT in Cervical Cancer. Masters thesis, Cancer Institute (W. I. A.), Chennai.


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INTRODUCTION: The worldwide incidence of cervical cancer is about 5,10,000 new cases annually with approximately 2,88,000 deaths occurring annually worldwide due to cervical cancer and in India about 1.25 lakh new cases and 80,000 deaths are reported every year from this disease accounting to nearly one third of global cervical cancer deaths. Unlike many other cancers, cervical cancers occurs during early stages of life and strikes the productive period of a woman’s life. The incidence rises at 30-34 years of age and peaks at 55-65 years, with a median age of incidence at 38 years. At present, the age-adjusted incidence rates for cervical cancer range from 19 to 44 per lakh women in various cancer registries of India. Indian women face a 2.5% cumulative lifetime risk of developing cervical cancer and 1.4% cumulative death risk from cervical cancer. Across the globe, cervical cancer incidence varies significantly with variation in cultural outlook towards sexual practices and differences in the mass screening programs. At our center, carcinoma cervix is the second-most common cancer among females, after Cancer Breast. The incidence of cervical carcinoma is more in populations with poor rates of cervical cancer screenings and high HPV infection. OBJECTIVE: To find whether Introducing Intracavitary Brachytherapy Early during EBRT in Cervical Cancer is Feasible. MATERIALS AND METHODS: Thirty patients of carcinoma cervix (FIGO-I B2-II B)who satisfy the inclusion criteria were included in this study: the study group was treated with concomitant EBRT and HDR-ICA (EBRT = 45 Gy/25 Fr, HDR 6 Gy in 4 Fr during the 5th, and 6th week) so that entire treatment can be completed within 6-7 weeks. EBRT and weekly cisplatin were not given on the day of HDR-ICA. Acute reactions were compared after treatment and at 6-month follow-up. RESULTS: So far 30 patients have completed the protocol treatment. About 70% of the study group developed grade I/ II genitourinary symptoms and 45% developed grade I-II gastro-intestinal symptoms and 25% developed grade III gastrointestinal symptoms. But all of these acute reactions were manageable conservatively. Except few patients who developed grade III GI symptoms, none of the patients required treatment interruption. 96% of study patients had complete response in terms of local control at the end of the treatment. Only 1 patient had residual disease at the end of treatment. Disease free survival at 6 monthly follow up was around 96%. CONCLUSION: Patients in the study group had better response but statistically insignificant. All acute reactions were easily manageable. It would be convenient for older women and people from far off places due to completion of treatment at a stretch. But this is too early to say a conclusion and larger number of patients and longer follow-up are required to arrive at concrete conclusions.

Item Type: Thesis (Masters)
Additional Information: 201719101
Uncontrolled Keywords: Concurrent EBRT and HDR, Decreasing OTT, Local response, Early reactions.
Subjects: MEDICAL > Radio Therapy
Depositing User: Subramani R
Date Deposited: 01 Feb 2021 04:53
Last Modified: 01 Feb 2021 04:53

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