Toxicity outcome of concurrent teletherapy and brachytherapy compared with teletherapy followed by brachytherapy in locally advanced carcinoma cervix
DOI:
https://doi.org/10.18203/2320-6012.ijrms20221789Keywords:
Carcinoma cervix, Teletherapy, Brachytherapy, CisplatinAbstract
Background: Teletherapy and intracavitary brachytherapy are definitive treatment modalities for stages IIB to IVA cervical carcinoma. Globally, it is the second most common cancer among female. Majority of patients attend the hospital with locally advanced stage due to less screening facility and social stigma.
Methods: This quasi-experimental study was conducted from January 2019 to June 2020 with a total of 76 patients. The patients were equally divided into two groups: A and B after obtaining their informed written consent.
Results: Final follow up was given after completion of treatment at 24 weeks. Patients in both groups developed grade 1 gastrointestinal and genitourinary toxicities (10.5% versus 13.1%, 13.1% versus 15.7% in group A and B respectively). Two patients in group A and three patients in group B developed grade 2 gastrointestinal toxicities. In genitourinary toxicities, grade 2 toxicities were observed in two patients of group A and four patients of group B, (p>0.05). None developed grade 3 and 4 gastrointestinal and genitourinary toxicities. There were no statistically significant variations in treatment related toxicities between the two groups.
Conclusions: Both gastrointestinal, genitourinary toxicities were comparable between two groups. The toxicities were acceptable and well tolerated.
References
WHO. Fact sheet: International Agency for Research on Cancer. GLOBOCAN 2020: Population fact sheets. Available at: http://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf. Accessed on 14 March 2022.
Koh W, Abu-Rustum NR, Bean S, Bradley K, Campos SM, Cho KR, et al. Cervical cancer, version 3.2019, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2019;17(1):64-84.
Fyles A, Keane TJ, Barton M. The effect of treatment duration in the local control of cervix cancer. Radiother Oncol. 1992;25(4):273-9.
Petereit DG, Sarkaria JN, Chappell R, Fowler JF, Hartman TJ, Kinsella TJ, et al. The adverse effect of treatment prolongation in cervical carcinoma. Int J Radiat Oncol Biol Phys. 1995;32(5):1301-7.
Schmidt-Ullrich RK, Contessa JN, Dent P, Mikkelson RB, Valerie K, Reardon DB, et al. Molecular mechanisms of radiation-induced accelerated repopulation. Radiat Oncol Investig. 1999;7(6):321-30.
Passi K, Kehwar TS, Mittal M, Singh B, Vashistha R, Gupta SJ, et al. Effectiveness of two different HDR brachytherapy regimens with the same BED value in cervical cancer. J Contemp Brachytherapy. 2010;2(2):53-60.
Schefter T, Winter K, Kwon JS, Stuhr K, Balaraj K, Yaremko BP, et al. RTOG 0417: efficacy of bevacizumab in combination with definitive radiation therapy and cisplatin chemotherapy in untreated patients with locally advanced cervical carcinoma. Int J Radiat Oncol Biol Phys. 2014;88(1):101-5.
Buekers TE, Anderson B, Sorosky JI, Buller RE. Ovarian function after surgical treatment for cervical cancer. Gynecolog Oncol. 2001;80(1):85-8.
Badar F, Anwar N, Meerza F, Sultan F. Cervical carcinoma in a Muslim community. Asian Pacif J Cancer Prevent. 2007;8(1):24.
Bandyopadhyay A, Basu P, Roy K, Das S, Banerjee S. Treatment of locally advanced carcinoma cervix with special emphasis on brachytherapy: a practice pattern survey among young radiation oncologist of India. South Asian J Cancer. 2018;7(04):231-5.
Nag S, Erickson B, Thomadsen B, Orton C, Demanes JD, Petereit D, et al. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys. 2000;48(1):201-11.
Foroudi F, Bull CA, Gebski V. Radiation therapy for cervix carcinoma: benefits of individualized dosimetry. Clin Oncol. 2002;14(1):43-9.
Sundar S, Symonds P, Deehan C. Tolerance of pelvic organs to radiation treatment for carcinoma of cervix. Clin Oncol. 2003;15(5):240-7.
Tharavichitkul E, Klunkin P, Lorvidhaya V, Sukthomya V, Chakrabandhu S, Pukanhapan N, et al. The effect of two HDR brachytherapy schedules in locally advanced cervical cancer treated with concurrent chemoradiation: a study from Chiang Mai, Thailand. J Radiat Res. 2012;53(2); 281-7.
