Clinical results of external beam radiotherapy alone with a concomitant boost program or with conventional fractionation for cervical cancer patients who did not receive intracavitary brachytherapy

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.

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Clinical Results Of External Radiotherapy Alone With 3DCRT For Cervical Cancer: Can We Provide Better Local Control Without Combination Treatment Including Intracavitary Brachytherapy?

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2011.06.1005 ◽

2011 ◽

Vol 81 (2) ◽

pp. S468-S469

Author(s):

K. Matsuura ◽

T. Okabe ◽

Y. Akagi ◽

K. Fujita ◽

M. Kagemoto

Keyword(s):

Cervical Cancer ◽

Local Control ◽

Combination Treatment ◽

Clinical Results ◽

Intracavitary Brachytherapy ◽

External Radiotherapy ◽

Radiotherapy Alone

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Bowel Morbidity in Locally Advanced Cervical Cancer Patients Treated with Combined External Beam Radiotherapy, Image-Guided Adaptive Brachytherapy (IGABT) and Concomitant Chemotherapy; a Descriptive Analysis from the Embrace Study

Brachytherapy ◽

10.1016/j.brachy.2016.04.070 ◽

2016 ◽

Vol 15 ◽

pp. S54-S55 ◽

Cited By ~ 2

Author(s):

N. B.K. Jensen ◽

L.U. Fokdal ◽

K. Kirchheiner ◽

C. Haie-Meder ◽

U. Mahantshetty ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Patients ◽

External Beam Radiotherapy ◽

Descriptive Analysis ◽

Locally Advanced ◽

External Beam ◽

Advanced Cervical Cancer ◽

Concomitant Chemotherapy ◽

Locally Advanced Cervical Cancer ◽

Image Guided

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Combination external beam radiotherapy and high-dose-rate intracavitary brachytherapy for uterine cervical cancer: Analysis of dose and fractionation schedule

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(03)00288-8 ◽

2003 ◽

Vol 56 (5) ◽

pp. 1344-1353 ◽

Cited By ~ 63

Author(s):

Takafumi Toita ◽

Yasumasa Kakinohana ◽

Kazuhiko Ogawa ◽

Genki Adachi ◽

Hidehiko Moromizato ◽

...

Keyword(s):

Cervical Cancer ◽

Dose Rate ◽

External Beam Radiotherapy ◽

Uterine Cervical Cancer ◽

High Dose Rate ◽

Intracavitary Brachytherapy ◽

High Dose ◽

External Beam ◽

Fractionation Schedule

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Individually customised parametrial boost for locally advanced cervical cancer: is 2D planned external beam radiotherapy useful?

Journal of Radiotherapy in Practice ◽

10.1017/s146039691900058x ◽

2019 ◽

Vol 19 (3) ◽

pp. 248-253

Author(s):

Aparna Gangopadhyay ◽

Subrata Saha

Keyword(s):

Cervical Cancer ◽

External Beam Radiotherapy ◽

Locally Advanced ◽

Intracavitary Brachytherapy ◽

External Beam ◽

Advanced Cervical Cancer ◽

Locally Advanced Cervical Cancer ◽

Pelvic Wall ◽

Significant Difference ◽

Median Period

AbstractAim:Pelvic wall control and toxicity was retrospectively assessed in patients who received individually customised parametrial boost (PMB) for locally advanced cervical cancer with 2D planned external beam radiotherapy. Outcomes of a dose-escalated combined boost were also evaluated.Materials and methods:Toxicity and pelvic wall recurrence was evaluated over a median period of 24 months between two groups who received different pelvic wall doses. One group was randomised to receive either intracavitary brachytherapy (ICRT) with an external beam PMB using a customised midline shield, or a dose-escalated combined boost with interstitial brachytherapy (ISBT) and PMB. The comparator group received no PMB.Results:At 24 months, pelvic wall recurrence occurred in 2/112 and 40/130 with and without PMB, respectively (p < 0·000001). No significant difference in toxicity was noted between boost versus no-boost groups (p = 0·56). Combined ISBT/PMB dose escalation showed no significant difference in pelvic wall recurrence compared with PMB alone (p = 0·49).Findings:Individually customised 2D PMBs with 3D image-based ICRT was safe and improved pelvic wall control in locally advanced cervix cancer. Dose-escalated combined boosts offered no significant benefit over standard boost doses.

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