Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study
Background: Cervical cancer is the common cancer cause of death among women in developing countries. High Dose Rate (HDR) intracavitary brachytherapy that is given with or sequential after EBRT, is an integral component in the treatment of carcinoma of the cervix. In recent years, High Dose Rate (HD...
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| Language: | English |
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West Asia Organization for Cancer Prevention
2024-01-01
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| Series: | Asian Pacific Journal of Cancer Care |
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| Online Access: | http://www.waocp.com/journal/index.php/apjcc/article/view/1176 |
| _version_ | 1797341941539536896 |
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| author | Mayur Khandelwal Divya Sharma Anjali T Shankar Lal Jakhar |
| author_facet | Mayur Khandelwal Divya Sharma Anjali T Shankar Lal Jakhar |
| author_sort | Mayur Khandelwal |
| collection | DOAJ |
| description | Background: Cervical cancer is the common cancer cause of death among women in developing countries. High Dose Rate (HDR) intracavitary brachytherapy that is given with or sequential after EBRT, is an integral component in the treatment of carcinoma of the cervix. In recent years, High Dose Rate (HDR) brachytherapy in combination with External Beam Radiotherapy (EBRT) has been popular in the management of carcinoma of the cervix.
Objectives: To evaluate treatment response post 3 and 6 months after treatment completion and treatment-related toxicities during treatment in weekly v/s biweekly HDR intracavitary brachytherapy after concomitant chemoradiation in squamous cell carcinoma cervix patients.
Methods: A total of 60 cervical cancer patients fulfilling the inclusion criteria were selected. Patients were randomly assigned to the weekly and Biweekly HDR ICBT using the chit-box method with replacement. Arm A (Study arm): 30 patients with concurrent EBRT (50 Gy/25 fractions with 2 Gy per fraction) with weekly cisplatin (35 mg/m2) followed by HDR-ICBT 5 Gy * 5 fractions biweekly after completion of EBRT. Arm B (Control arm): 30 patients with concurrent EBRT (50 Gy/25 fractions with 2 Gy per fraction) with weekly cisplatin (35 mg/ m2) followed by HDR - ICBT 7.5 Gy * 3 fractions weekly after completion of EBRT.
Results: Patients were assessed at 3 and 6 months to determine the local disease response and the incidence of any toxicities assessed during the treatment. All responses were graded as either CR (complete response), PR (partial response), SD (stable disease), or PD (progressive disease). 30 patients were assessed for therapy response using the WHO criteria. At 3 months arm A showed 86% CR and arm B showed 90% CR. 2 patients in arm A and 1 patient in arm B had PR. In both arms 2 patients had progressive disease. At 6 months 1 patient in both arms who had progressive disease converted into partial response after taking post RT chemotherapy.
Conclusions: To sum up, brachytherapy is a vital aspect of the process of treating cervical cancer. Several centers have experimented with various doses and fractionation regimes. Patients in the current trial reported no safety concerns or intolerability issues across any treatment protocol. Arm A had treatment completion before arm B with comparable disease response and toxicities. Therefore, the choice of treatment plan depends on the individual patient’s circumstances and the institution’s demands. nonetheless, longer follow-ups and a bigger patient sample are needed for a solid evaluation of disease response and toxicity. |
| first_indexed | 2024-03-08T10:26:15Z |
| format | Article |
| id | doaj.art-0f651442531a4c27b4ab04593b488483 |
| institution | Directory Open Access Journal |
| issn | 2588-3682 |
| language | English |
| last_indexed | 2024-03-08T10:26:15Z |
| publishDate | 2024-01-01 |
| publisher | West Asia Organization for Cancer Prevention |
| record_format | Article |
| series | Asian Pacific Journal of Cancer Care |
| spelling | doaj.art-0f651442531a4c27b4ab04593b4884832024-01-27T07:09:22ZengWest Asia Organization for Cancer PreventionAsian Pacific Journal of Cancer Care2588-36822024-01-0191151910.31557/apjcc.2024.9.1.15-191176Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective StudyMayur Khandelwal0Divya Sharma1Anjali T2Shankar Lal Jakhar3Department of Radiation Oncology, Sardar Patel Medical College, Bikaner (Rajasthan), India.Department of Radiation Oncology, Sardar Patel Medical College, Bikaner (Rajasthan), India.Department of Radiation Oncology, Sardar Patel Medical College, Bikaner (Rajasthan), India.Department of Radiation Oncology, Sardar Patel Medical College, Bikaner (Rajasthan), India.Background: Cervical cancer is the common cancer cause of death among women in developing countries. High Dose Rate (HDR) intracavitary brachytherapy that is given with or sequential after EBRT, is an integral component in the treatment of carcinoma of the cervix. In recent years, High Dose Rate (HDR) brachytherapy in combination with External Beam Radiotherapy (EBRT) has been popular in the management of carcinoma of the cervix. Objectives: To evaluate treatment response post 3 and 6 months after treatment completion and treatment-related toxicities during treatment in weekly v/s biweekly HDR intracavitary brachytherapy after concomitant chemoradiation in squamous cell carcinoma cervix patients. Methods: A total of 60 cervical cancer patients fulfilling the inclusion criteria were selected. Patients were randomly assigned to the weekly and Biweekly HDR ICBT using the chit-box method with replacement. Arm A (Study arm): 30 patients with concurrent EBRT (50 Gy/25 fractions with 2 Gy per fraction) with weekly cisplatin (35 mg/m2) followed by HDR-ICBT 5 Gy * 5 fractions biweekly after completion of EBRT. Arm B (Control arm): 30 patients with concurrent EBRT (50 Gy/25 fractions with 2 Gy per fraction) with weekly cisplatin (35 mg/ m2) followed by HDR - ICBT 7.5 Gy * 3 fractions weekly after completion of EBRT. Results: Patients were assessed at 3 and 6 months to determine the local disease response and the incidence of any toxicities assessed during the treatment. All responses were graded as either CR (complete response), PR (partial response), SD (stable disease), or PD (progressive disease). 30 patients were assessed for therapy response using the WHO criteria. At 3 months arm A showed 86% CR and arm B showed 90% CR. 2 patients in arm A and 1 patient in arm B had PR. In both arms 2 patients had progressive disease. At 6 months 1 patient in both arms who had progressive disease converted into partial response after taking post RT chemotherapy. Conclusions: To sum up, brachytherapy is a vital aspect of the process of treating cervical cancer. Several centers have experimented with various doses and fractionation regimes. Patients in the current trial reported no safety concerns or intolerability issues across any treatment protocol. Arm A had treatment completion before arm B with comparable disease response and toxicities. Therefore, the choice of treatment plan depends on the individual patient’s circumstances and the institution’s demands. nonetheless, longer follow-ups and a bigger patient sample are needed for a solid evaluation of disease response and toxicity.http://www.waocp.com/journal/index.php/apjcc/article/view/1176concomitant chemoradiation, high dose rate intracavitary brachytherapy , cervical cancer, treatment response, late toxicity. |
| spellingShingle | Mayur Khandelwal Divya Sharma Anjali T Shankar Lal Jakhar Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study Asian Pacific Journal of Cancer Care concomitant chemoradiation, high dose rate intracavitary brachytherapy , cervical cancer, treatment response, late toxicity. |
| title | Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study |
| title_full | Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study |
| title_fullStr | Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study |
| title_full_unstemmed | Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study |
| title_short | Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study |
| title_sort | compare two different fractionated regimes of hdr intracavitary brachytherapy after concomitant chemoradiation in carcinoma cervix a prospective study |
| topic | concomitant chemoradiation, high dose rate intracavitary brachytherapy , cervical cancer, treatment response, late toxicity. |
| url | http://www.waocp.com/journal/index.php/apjcc/article/view/1176 |
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