Acute toxicity profile of three-dimensional conformal concurrent chemoradiation in carcinoma cervix: an institutional experience

2020 ◽  
Vol 19 (4) ◽  
pp. 355-358
Author(s):  
Rajanigandha Tudu ◽  
Anup Kumar ◽  
Rashmi Singh ◽  
Payal Raina
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Three Dimensional ◽  
Concurrent Chemoradiation ◽  
Definitive Treatment ◽  
Cancer Cervix ◽  
Carcinoma Cervix ◽  
Treatment Interruptions ◽  
Locally Advanced Cancer ◽  
3D Crt

AbstractBackground:Concurrent chemoradiation is the definitive treatment for advanced cervical cancer. Pelvic radiation is known to damage the adjacent normal tissues thereby causing acute toxicities. The modern conformal radiation techniques like three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy are known to reduce the toxicities and improve clinical outcomes.Aim:To retrospectively evaluate the frequency and severity of acute toxicities encountered during concurrent chemoradiation of locally advanced cancer cervix treated with 3D-CRT.Methods:The medical case records of 174 cervical cancer patients treated between November 2015 and November 2018 were studied. One hundred and thirteen histologically proven locally advanced cancer cervix patients (Stage IIB–IIIB) treated with concurrent 3D conformal chemoradiation between were included in the study. Patients received 46 Gy in 23 fractions with concurrent weekly cisplatin (40 mg/m2) on days 1, 8, 15 and 22 of radiation. The study endpoints were treatment-related toxicities which were graded according to CTCAE version 5.0.Results:One hundred and thirteen patients were analysed for the study. Gastrointestinal toxicity was the predominant toxicity observed followed by haematological toxicity. 31·7% patients reported grade 1–2 diarrhoea and 39·7% reported grade 1–2 leucopenia. None of the patients reported grade 3 or higher toxicities. Treatment interruptions were noted due to these toxicities.Conclusion:Concurrent chemoradiation is the definitive treatment for locally advanced carcinoma cervix with acceptable toxicities. Proper management measures should be undertaken for these toxicities to avoid treatment interruptions and ensure better treatment compliance.

THREE-DIMENSIONAL PLANNING OF BRACHYTHERAPY FOR LOCALLY ADVANCED CERVICAL CANCER BY CT/MRI IMAGES

2018 ◽  
Vol 64 (5) ◽  
pp. 645-650
Author(s):  
Olga Kravets ◽  
Yelena Romanova ◽  
Oleg Kozlov ◽  
Mikhail Nechushkin ◽  
A. Gavrilova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Local Control ◽  
Control Volume ◽  
Locally Advanced ◽  
Three Dimensional ◽  
Advanced Cervical Cancer ◽  
3D Ct ◽  
Mri Imaging ◽  
Tumor Target ◽  
Locally Advanced Cervical Cancer

We present our results of 3D CT/MRI brachytherapy (BT) planning in 115 patients with locally advanced cervical cancer T2b-3bN0-1M0. The aim of this study was to assess the differences in the visualization of tumor target volumes and risk organs during the 3D CT/MRI BT. The results of the study revealed that the use of MRI imaging for dosimetric planning of dose distribution for a given volume of a cervical tumor target was the best method of visualization of the soft tissue component of the tumor process in comparison with CT images, it allowed to differentially visualize the cervix and uterine body, directly the tumor volume. Mean D90 HR-CTV for MRI was 32.9 cm3 versus 45.9 cm3 for CT at the time of first BT, p = 0.0002, which is important for local control of the tumor process. The contouring of the organs of risk (bladder and rectum) through MRI images allows for more clearly visualizing the contours, which statistically significantly reduces the dose load for individual dosimetric planning in the D2cc control volume, і.є. the minimum dose of 2 cm3 of the organ of risk: D2cc for the bladder was 24.3 Gy for MRI versus 34.8 Gy on CT (p = 0.045); D2cc for the rectum - 18.7 Gy for MRI versus 26.8 Gy for CT (p = 0.046). This is a prognostically important stage in promising local control, which allows preventing manifestation of radiation damage.

scholarly journals Dosimetric Comparison between High Dose Rate Brachytherapy Boost and Volumetric Arc Therapy Boost in Locally Advanced Cancer Cervix

2021 ◽  
Vol 07 (02) ◽  
pp. 085-088
Author(s):  
Hanady Hegazy ◽  
Neamat Hegazy ◽  
Maher Soliman ◽  
Amr Elsaid
Keyword(s):  
Small Bowel ◽  
Dose Rate ◽  
Advanced Cancer ◽  
Locally Advanced ◽  
Target Volume ◽  
High Dose Rate ◽  
High Dose ◽  
Cancer Cervix ◽  
Arc Therapy ◽  
Locally Advanced Cancer

AbstractConcurrent chemoradiotherapy is considered the standard treatment for the locally advanced cancer cervix (LACC). Radiotherapy is commonly administered by a three-dimensional conformal radiotherapy (3DCRT) approach followed by brachytherapy (BT). High dose rate (HDR) BT is commonly administered; however, several drawbacks exist including invasive technique, pain, requirement of anesthesia, and operative risks. We assessed the dosimetric difference between the HDR BT and the volumetric modulated arc therapy (VMAT) boost in those patients. Ten patients were selected retrospectively with LACC and all received whole pelvis radiotherapy followed by BT boost of 7 Gy in three fractions. The computed tomography (CT) image was transferred to the Varian system for the VMAT plan while the one with the applicator was transferred to the Sagi planning system and the high-risk clinical target volume (HR-CTV), bladder, rectum, sigmoid, and small bowel were delineate with a margin of 5 mm were added to the CTV to create the planning target volume (PTV). The D90 for the PTV in VMAT boost was lower than received by the HR-CTV in the BT boost. Mean volume of the PTV was higher than that of the HR-CTV. The D2cc was higher in VMAT for bladder, sigmoid, and rectum while the D2cc for the small bowel in BT was higher compared with the VMAT. The VMAT is an option that exists for patients who refuse BT or cannot tolerate it, or in case of nonavailability of BT or a nonworking machine.

Three-dimensional dose accumulation in pseudo-split-field IMRT and brachytherapy for locally advanced cervical cancer

Brachytherapy ◽  
2015 ◽  
Vol 14 (4) ◽  
pp. 481-489 ◽  
Author(s):  
Baozhou Sun ◽  
Deshan Yang ◽  
Jackie Esthappan ◽  
Jose Garcia-Ramirez ◽  
Samantha Price ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Three Dimensional ◽  
Advanced Cervical Cancer ◽  
Dose Accumulation ◽  
Locally Advanced Cervical Cancer ◽  
Split Field

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.

The role of additional hysterectomy after concurrent chemoradiation for patients with locally advanced cervical cancer

2019 ◽  
Vol 25 (2) ◽  
pp. 384-390 ◽  
Author(s):  
Kosuke Yoshida ◽  
Hiroaki Kajiyama ◽  
Masato Yoshihara ◽  
Satoshi Tamauchi ◽  
Yoshiki Ikeda ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Concurrent Chemoradiation ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer
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