INTERSTITIAL BRACHYTHERAPY IN THE MANAGEMENT OF UTERINE CERVICAL CANCER- SINGLE INSTITUTIONAL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 50
Abstract
BACKGROUND The objective of this study is to report the clinical outcome of patients with carcinoma cervix treated by radiation therapy including brachytherapy (BT), using template based Interstitial Brachytherapy (ISBT), in whom conventional Intracavitary Application (ICA) is not possible and to determine the local control and the acute and late radiation induced toxicities. MATERIALS AND METHODS From Apr 2016 to Mar 2018, among histologically proven cervical cancer patients, 30-70 yrs. of age, stages from IB to IIIB, completed concurrent chemo-radiation (radical/adjuvant) and referred for High Dose Rate Brachytherapy (HDR BT), thirty patients, in whom conventional ICA is not possible are treated using template based, image guided ISBT. The dose prescribed per fraction of HDR-ISBT in our institute varied from 3-4 Gy/fraction to a total of 12-21 Gy in 4-6 fractions. D90 for HR-CTV of BT, cumulative EQD2 of HR-CTV and the cumulative D2cc for the bladder, rectum, and sigmoid, (Combined EBRT and BT) were analysed. Patients were evaluated for disease related parameters, treatment-related toxicities and tumour-response rates at 6 weeks, then every month for first 3 months and every 3 months thereafter. MRI is done at end of 3 months. RESULTS Among 735 patients referred for brachytherapy, 30 patients, who are not fit for conventional ICA, are treated by HDR ISBT.19 patients were using Syed-Neblett and 11 using Mupitz template. Median number of needles used was 15. The median BT Dose planned was 23.6 Gy and median HR-CTV D90 was 17.5 Gy. The median cumulative EQD2 for HR-CTV, D2cc for the bladder, rectum, and sigmoid were 67.5, 62.6, 64.36, 54.83 Gy respectively. The median V100 for HR-CTV was 70 ml. Local control (LC) rate at first follow up (3 months) is 43.3% and at 1 yr. is 41.38 %. The median Progression-free survival time for two year follow up was 19.92 months. One patient (3.33%) had distant metastasis, two patients (6.67%) experienced grade 2 rectal bleeding but none had bladder complications. CONCLUSION Treatment by image guided ISBT for carcinoma cervix patients in whom conventional application is not possible, results in good dose-volume histogram values and favourable local control with acceptable toxicities, is depicted through this prospective single institutional study with a lesser number of patients.
Authors and Affiliations
Thirukurungudi Narayanan Vijayasree, Subramanian Saravanan
Keywords
Related Articles
- EP ID EP549313
- DOI 10.14260/jemds/2018/1188
- Views 59
- Downloads 0
COMPARATIVE STUDY OF CARDIOVASCULAR RESPONSE TO LMA INSERTION AND ENDOTRACHEAL TUBE INTUBATION
BACKGROUND Tracheal intubation is performed routinely during general anaesthesia to secure the airway, to facilitate ventilation of the lungs, for control of partial pressures of oxygen and carbon dioxide in arterial blo...
INTRARENAL HAEMODYNAMIC IN TYPE 2 DIABETICS MELLITUS AND ITS CORRELATION WITH BIOCHEMICAL PARAMETERS
[b]AIMS & OBJECTIVES[/b]: The evaluation of resistance index of interlobar artery on Color Doppler imaging in type 2 diabetes mellitus patients and comparison with healthy controls and the Correlation amon...
PREVALENCE OF AUTOIMMUNE THYROID DISEASE AND THYROID DYSFUNCTION IN TYPE 1 DIABETES MELLITUS PATIENTS- A TERTIARY CARE CENTRE BASED STUDY IN ASSAM MEDICAL COLLEGE AND HOSPITAL, DIBRUGARH, ASSAM
BACKGROUND Patients with an autoimmune condition are known to be at higher risk of developing other autoimmune disorders. Type 1 diabetes mellitus may be associated with additional autoimmune disorders including autoimmu...
STUDY ON PREVALENCE OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS; COMPARISON OF FOUR DIAGNOSTIC METHODS FOR DETECTING MRSA– FROM A TERTIARY CARE HOSPITAL, MADURAI
BACKGROUND Prevalence of Methicillin-Resistant Staphylococcus aureus (MRSA) in India ranges from 30 to 70% which leads to high mortality, increased economic burden and high treatment failure when compared to MSSA. Rapid...
A DESCRIPTIVE STUDY ON OVARIAN MASSES IN ADOLESCENTS IN MCH, KOTTAYAM
BACKGROUND It is recommended that greater use of imaging of the pelvis and tumour markers preoperatively is essential for evaluation of adolescent ovarian masses. There should be greater use of conservative expectant man...