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Background: Majority of Indian patients presents in locally advanced stage and most of them treated by combination of external teletherapy and intracavitary brachytherapy (ICRT). Because of deficient infrastructure, the waiting period is generally long at existing caner canters. Hence ICRT may be done in conscious sedation to treat more patients by avoiding time consuming general anaesthesia. The aim of this study is to know the effect of general anaesthesia vs. conscious sedation in dosimetric distribution in brachytherapy and its feasibility.Methods: Total 80 ICRT applications were randomized to general anaesthesia (GA) and conscious sedation (CS) groups. Fletcher suit type of applicators was used and dose delivery equipment was cobalt 60 high dose rate remote after loading brachytherapy unit. In CS group, injection midazolam 0.5-8mg (median 2.5mg) in the form of slow i.v. infusion was used along with antiemetic support.Results: Total 6 parameters were analyzed. e.g., Dose to point A1, Dose to point A2, Bladder max dose, Bladder mean dose, Rectal max dose and Rectal mean dose. The dose distribution was found similar both   groups and it did not depend on type of anaesthesia.Conclusions: The high volume centers of developing countries are most suitable candidate to opt conscious sedation to perform ICRT to treat more cancer cervix patients in same time frame.

Background: Anatomic complexity is a challenge for radiation oncologist.Repeated CT scans and replanning can overcome the variations in terms of size or shape a tumour has undergone during treatment , this process has been termed as Adaptive Radiotherapy(ART). The use of adaptive approach or IMRT-SIB is still under debate since there is not enough evidence of long-term clinical outcomes , metastasis free survival. Total Sixty patients Materials And Methods: with locally advanced HNC with a intent to cure were assigned into two arms to receive IMRT up to a dose of 70 Gy with concurrent weekly chemotherapy and were prospectively analyzed between March 2018 and March 2019. Repeat CT scan was acquired after the 3rd week of radiation and those in the study arm were replannned and those in the controlarm continued with the rst IMRT plan. For the entire cohort, patients were assessed weekly till the end of treatment and at 1, 3, and6 months, 1 year and 2 years thereafter. Main focus was on Xerostomia status at end of 6 months and end of 2 years and Survival (OS) rates at end of 2-years was calculated and hence compared. 2 years overall survival rate wa Results: s almost similar with 73.33% vs 76.66% in adaptive IMRTand conventional IMRT respectively; p value= 0. 23 Xerostomia was statistically signicantly higher in the conventional arm at 6 months(p=0.01).Grade ≥II xerostomia at end of 2 years reduced to 0% vs 4.43 %in adaptive and conventional IMRT respectively (p= 0.78). Conclusion: Adaptive IMRT can help to minimise xerostomia at end of 6 months .However no major benet in survival when compared 2 year after completion of treatment.

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