Optimum Radiation Fractionation Schedule in Advanced Cancer Cervix; A Study from Low Resource North Indian Cancer Center

Abstract

Introduction: Cervical cancer is the fourth most commonly occurring lethal cancer among women worldwide. The primary curative treatment option for women suffering from locally advanced cervical cancer includes external beam radiotherapy (EBRT) with concurrent weekly platinum-based radiosensitizing chemotherapy and brachytherapy (BT) to obtain finest treatment outcomes.
Aim: The purpose of this study is to assess tumor response following HDRBT preceded by EBRT and to identify optimum radiation fractionation schedule for better response with tolerable radiation toxicity.
Material and methods: 91 patients diagnosed with carcinoma of uterine cervix were screened for inclusion in the study. Patients were categorized according to FIGO Staging system The patient was put in lithotomy position and given anesthesia and fletcher suit applicator was applied to the patient push the bladder and rectum and finally shifted to the HDR treatment unit. All the associations were tested by using chi square test.
Results: In our study it was found that majority (44%) of the cases were aged 51-60 years. Vaginal bleeding and squamous cell carcinoma was found in most of the cases. The acute radiation toxicities were more in elderly age group and the association was found to be statistically significant (p<0.05) except Genitourinary – cystitis. Age group 51-60 years was significantly associated with response (p=0.034) with lower risk of partial response (OR=0.31 (0.10-0.95), while the symptom Backache/Pain in abdomen had significantly higher risk of partial response (p=0.002, OR=16.24 (1.7-154.8).
Conclusion: When compared to traditional techniques, HDR can achieve very high rates of local control while lowering morbidity.