Comparison of dose delivered to vagina using two different intracavitary brachytherapy applicators for carcinoma cervix

Brachytherapy ◽  
2021 ◽  
Author(s):  
Harjot Kaur Bajwa ◽  
Anil Kumar Talluri ◽  
Aijaz Maqbool ◽  
Devender Reddy ◽  
Rohith Singareddy ◽  
...  
Keyword(s):  
Intracavitary Brachytherapy ◽  
Carcinoma Cervix

scholarly journals Comparative study to evaluate dosimetric differences in patients of locally advanced carcinoma cervix undergoing intracavitary brachytherapy under two different anaesthesia techniques: an audit from a tertiary cancer centre in India

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Divyesh Kumar ◽  
G. Y. Srinivasa ◽  
Ankita Gupta ◽  
Bhavana Rai ◽  
Arun S. Oinam ◽  
...  
Keyword(s):  
Day Care ◽  
Treatment Time ◽  
Locally Advanced ◽  
Effective Alternative ◽  
External Beam Radiation ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Carcinoma Cervix ◽  
Beam Radiation ◽  
Significant Difference

Abstract Background Carcinoma cervix is amongst the leading causes of mortality and morbidity in women population worldwide. High-dose-rate intracavitary brachytherapy (HDR-ICBT) post external beam radiation therapy (EBRT) is the standard of care in managing locally advanced stage cervical cancer patients. HDR-ICBT is generally performed under general anaesthesia (GA) in operation theatre (OT), but due to logistic reasons, sometimes, it becomes difficult to accommodate all patients under GA. Since prolonged overall treatment time (OTT) makes the results inferior, taking patients in day care setup under procedural sedation (PS) can be an effective alternative. In this audit, we tried to retrospectively analyse the dosimetric difference, if any, in patients who underwent ICBT at our centre, under either GA in OT or PS in day care. Results Thirty five patients were analysed 16/35 (45.71%) patients underwent HDR-ICBT under GA while 19/35 (54.28%) patients under PS. In both groups, a statistically significant difference was observed between the dose received by 0.1 cc as well as 2 cc of rectum (p < 0.05), while the bladder and sigmoid colon had comparable dosages. Conclusion Though our dosimetric analysis highlighted better rectal sparing in patients undergoing HDR-ICBT under GA when compared to patients under PS, PS can still be considered an effective alternative, especially in centres dealing with significant patient load. Further studies are required for firm conclusion.

A PROSPECTIVE RANDOMIZED STUDY TO COMPARE THE CONCURRENT CHEMO-RADIATION VERSUS HYPO-FRACTIONATED CHEMO-RADIATION IN LOCALLY ADVANCED CERVICAL CANCER.

2021 ◽  
pp. 40-42
Author(s):  
Arpan Jana ◽  
Pabitra Das ◽  
Poulami Gupta ◽  
Phalguni Gupta
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Intracavitary Brachytherapy ◽  
External Beam ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma

Background: Concurrent chemo-radiation is the standard treatment worldwide for locally advanced squamous Cell carcinoma cervix. However, conventional chemo-radiotherapy is also associated with unacceptable local and systemic failure rates for locally advanced disease. Biologically squamous cell carcinoma of head- neck cancer and cervical cancer behaves quite similarly in response to radiotherapy. So, it can be expected that, altered fractionation can increase the local control in case of squamous cell carcinoma cervix than conventional radiotherapy. There is no randomised control trial for carcinoma cervix till date, which compares conventional chemo-radiation with hypo-fractionated chemo-radiation. Aims And Objectives: The present study was planned to compare local disease control and acute toxicity of conventional chemo-radiation with hypo-fractionated chemo-radiation in locally advanced carcinoma cervix. Materials And Methods: In Conventional Chemo-radiation Arm A patients (n=30) received external beam radiotherapy 50 Gy in 25 fractions in 5 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 7 Gy per fraction once in a week for 3 weeks. The second group of hypo-fractionated Arm B received external beam radiotherapy 45 Gy in 20 fractions in 4 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 9 Gy per fraction once in a week for 2 weeks. Results: Grade II diarrhea were seen more in Arm B 17 (56.66%) compare to Arm A 12(40%) and grade III diarrhea was seen 4 (3.33%) in Arm B and 2(6.66%) in Arm A. At 2 months and 6 months after completion of treatment Complete response were 25 (83.4%) in Arm A compare to 22 (73.3%) in Arm B and 20 (74.1%) in Arm A and 18 (72%) in Arm B respectively. Conclusion: Hypo-fractioned radiotherapy may be used as an alternate protocol for treatment of locally advanced carcinoma cervix with acceptable toxicities.

Use of misoprostol before tandem application for intracavitary brachytherapy in patients of carcinoma cervix: An institution study

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Virendra Bhandari ◽  
Tauseef Ali ◽  
Sahaj Palod ◽  
Aafreen Khan ◽  
Shalu Verma ◽  
...  
Keyword(s):  
Intracavitary Brachytherapy ◽  
Carcinoma Cervix

Doses to Pelvic Bone Marrow from Intracavitary Brachytherapy in Carcinoma Cervix: A Dosimetric Study

Brachytherapy ◽  
2016 ◽  
Vol 15 ◽  
pp. S116
Author(s):  
Ajeet Kumar Gandhi ◽  
Lakhan Kashyap ◽  
Priyanka Agarwal ◽  
Daya Nand Sharma ◽  
Goura Kishor Rath
Keyword(s):  
Bone Marrow ◽  
Intracavitary Brachytherapy ◽  
Pelvic Bone ◽  
Carcinoma Cervix ◽  
Dosimetric Study

scholarly journals Clinical comparison of toxicity pattern of two linear quadratic model-baesd fractionation schemes of high-dose-rate intracavitary brachytherapy for cervical cancer

2016 ◽  
Author(s):  
Ankit Batra
Keyword(s):  
Cervical Cancer ◽  
Dose Rate ◽  
High Dose Rate ◽  
Sub Saharan Africa ◽  
Quadratic Model ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Linear Quadratic ◽  
Carcinoma Cervix ◽  
Linear Quadratic Model

Introduction: Carcinoma cervix is the fourth (GLOBACON 2012) most common cancer among women worldwide, and the main cancer affecting women in Sub-Saharan Africa, Central America and south-central Asia. In India, approx. 1,23,000 (GLOBACON 2012) new cases of carcinoma cervix are diagnosed each year. Brachytherapy is an integral part of treatment of cancer cervix. In the context of a developing country like us where maximum utilization of the resource is of prime importance to provide treatment to the large patient cohort, shortening the treatment duration and number of fractions always increases efficiency. In order to maximize the logistic benefits of HDR-BT while improving patient compliance and resource sparing, various fractionation regimens are used. Fractionation and dose adjustments of the total dose are radiobiologically important factors in lowering the incidence of complications without compromising the treatment results. Aim: To compare patient outcomes and complications using two linear-quadratic model-based fractionation schemes of high-dose-rate intracavitary brachytherapy (HDR-IC) used to treat cervical cancer. Materials and Methods: A prospective randomized study on 318 patients, with histologically proven advanced carcinoma cervix (stages IIB-IIIB) was enrolled in the study. All patients received External Beam Radio Therapy (EBRT) 50 Gy in 25 fractions with concurrent chemotherapy (cisplatin 35 mg/m2) followed by IntraCavitary brachytherapy using high dose rate equipment. Patients were randomised after completion of EBRT into two arms: (1) Arm 1: HDR ICRT 6.5 Gy per fraction for 3 fractions, a week apart. (2) Arm 2: HDR ICRT, 9 Gy per fraction for 2 fractions, 1 week apart. On completion of treatment, patients were assessed monthly for 3 months followed by 3 monthly thereafter. Treatment response was assessed according to WHO criteria after one month of completion of radiotherapy. The RTOG criteria were used for radiation induced toxicities. We analyzed late toxicities in terms of Rectal, Bladder, Small Bowel toxicity and Vaginal Stenosis. Results: Acute reactions in both the groups were comparable. None of the patient developed Grade 4 toxicity in our study and no toxicity related mortality was encountered. A slightly high frequency of late toxicity was observed in 9Gy Arm patients but was not statistically significant. Conclusion: In our setup, HDR brachytherapy at 9 Gy per fraction in two fractions is safe, effective and resource saving method with good local control, survival, and manageable normal tissue toxicity.

Dosimetric analysis of the effect of bladder volume on brachytherapy dose to organs at risk (OARs) in volume based intracavitary brachytherapy of carcinoma cervix: An institutional study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17006-e17006
Author(s):  
Jyoti Poddar ◽  
Ashutosh Das Sharma ◽  
U Suryanarayan K ◽  
Sonal Patel Shah ◽  
Ankita Parikh
Keyword(s):  
At Risk ◽  
Radiation Dose ◽  
Sigmoid Colon ◽  
Organs At Risk ◽  
Pearson Correlation ◽  
Bladder Volume ◽  
Intracavitary Brachytherapy ◽  
P Value ◽  
Hdr Brachytherapy ◽  
Carcinoma Cervix

e17006 Background: External beam radiotherapy combined with intracavitary brachytherapy is the standard of care in Carcinoma cervix. Due to its characteristics of rapid dose fall off, brachytherapy limits the toxicity to organs at risk while escalating radiation dose to target. Still, the organs near the radioactive source are at risk of considerable exposure, toxicity and post treatment morbidity. Alteration of bladder volume, alters the relative anatomy of uterus, rectum, sigmoid colon causing changes in the radiation dose to these organs. Methods: Aim:To correlate between the bladder volume and its effects on the dose received by bladder, rectum and sigmoid colon in volume based HDR brachytherapy in carcinoma cervix.30 patients (78 Intracavitary Brachytherapy applications) of Carcinoma Cervix (FIGO stage II-III) treated with EBRT followed by volume based HDR brachytherapy at our institute between July 2014 to Jan 2016 were studied. Bladder volume data was tabulated into five groups according to increasing volume of bladder. It was correlated with D2cc dose received by bladder, rectum and sigmoid colon. Results: Statistical Analysis Linear regression and correlation analysisof the HRCTV with dose to the bladder was 0.2 (.i.e HRCTV does not influence the bladder dose.) Pearson correlation of bladder volume and D2cc bladder and D2cc rectum was positive for all groups and for sigmoid D2cc was positive for group B and negative for all other groups. P value = 0.064 Conclusions: Keeping the bladder volume low (<130 cc) during brachytherapy would reduce the dose to bladder and rectum and the probability of late bladder and rectal toxicity reduces. [Table: see text]

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