A Comparative Analysis of Two Different Dose Fractionation Regimens of High Dose Rate Intracavitary Brachytherapy in Treatment of Carcinoma of Uterine Cervix: A Prospective Randomized Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 4
Abstract
Introduction: High Dose Rate (HDR) intracavitary brachytherapy is an integral component in treatment of carcinoma uterine cervix. There is no consensus about optimal fractionation in HDR brachytherapy. Aim: To assess the feasibility, tolerability of HDR intracavitary brachytherapy schedule of 8 Gy per fraction per week for 3 fractions over 6Gy per fraction per week for 4 fractions with or without chemotherapy in the treatment of carcinoma of uterine cervix. Materials and Methods: From 2013 to 2014 total 80 patients with carcinoma of the uterine cervix (Stages IIB and IIIB) were treated with External Beam Radiotherapy (EBRT) and High Dose Rate Intracavitary Brachytherapy (HDR- ICBT). During course of EBRT, those patients fit for brachytherapy were randomized to arm A- 6 Gy per fraction per week for 4 fractions and arm B - 8 Gy per fraction per week for 3 fractions. Results: The median follow up was 30 months, local control was 90% in Arm A and 83.3% in Arm B (p= 0.21) and the diseasefree survival was 90% in Arm A and 83.3% in Arm B (p= 0.39). There is no significance difference for late rectal and bladder toxicities between two arms (p=0.43). Conclusion: Taking into account of increased hospital burden of locally advanced cancer cervix patients in Indian context, HDR intracavitary brachytherapy schedule of 8 Gy per fraction per week x 3 fractions is the preferable option over 6 Gy per fraction per week x 4 fractions with regard to comparable loco-regional control, acute and late toxicity, disease free survival and better patients compliance to lesser fractionation schedule.
Authors and Affiliations
Bonala Sreenivasa Rao, Pranabandhu Das, Bala venkata subramanian, Amitabh Jena, Patnayak Rashmi, V L Anusha Konakalla, kuna jayasree
Keywords
Related Articles
- EP ID EP339914
- DOI 10.7860/JCDR/2017/22489.9607
- Views 80
- Downloads 0
The Lipase Activities of Malassezia Species Isolated from Seborrhoeic Dermatitis/Dandruff Patients
ABSTRACT Introduction: Malassezia a commensal yeast, can become pathogenic leading to different clinical forms of dermatosis. Being an obligatory lipophilic, the lipolytic enzymes produced by them help in their growth by...
Accuracy of Sonographic Modules in the Estimation of Birth Weight: An Analytical Study of Antenatal Women in Enugu, Nigeria
ABSTRACT Introduction: Antenatal sonographic estimation of foetal weight is a common practice. The use of these estimates to predict actual birth weight is crucial for appropriate management of certain pregnancy conditio...
Gall Bladder Carcinoma with Concurrent Metastases to Bone (Sclerotic) and Urinary Bladder
Abstract Gall bladder carcinoma is an aggressive malignancy with varied presentation. Liver is most commonly involved initially with distant metastasis in virtually all possible organs. We report a case of middle aged fe...
A Novel Laboratory Technique of Fabricating a Definitive Hollow Obturator using Brown Sugar
ABSTRACT Obturators are prostheses that help to seal congenital or acquired tissue openings of hard, soft palate and adjacent structures and restore patient’s lost function, comfort and aesthetics. In the process of its...
Depression, its Correlates and Effects in Ever Married Urban Women Residing in Kumaon Region of Uttarakhand
ABSTRACT Introduction: In the global context, independent studies on depression show that women are twice as likely as men to suffer from clinical depression. It is also described as an important cause of premature morta...