The region of head and neck is critical for respiration, nutrition, and speech. The management of laryngeal tumours can stimulate mutilations and cosmetic deformities and worsen the life. A “non-operative approach” is preferred for patients to whom radiation following surgery, possibly, will direct severe functional destruction predominantly in advanced stage patients having a bulk of carcinoma larynx. The case material for the study was selected from the cross-section of patients registered at the J. K. Cancer Institute, Kanpur. Histologically squamous cell carcinoma 64 patients were registered and equally and randomly placed into Arm I and Arm II. “Arm I” patients and “Arm II” was comprised of randomly selected 64 patients, having histopathologically proven squamous cell carcinoma of the larynx. All patients (32 patients) belonging to “Arm I” received concurrent chemoradiotherapy of Inj. Cisplatin 100 mg/m2 for three-weekly underwent EBRT with 60 Co/LINAC and photon radiation of 70 Gy in 35 fractions for 7 weeks (2 parallel opposed fields). All the patients (32 patients) belongs to “Arm II” received chemo boost as Inj. Cisplatin 6 mg/m2 on last 15 fractions of treatment underwent EBRT with 60 Co/ LINAC photon radiation of 70 Gy in 35 fractions for 7 weeks. Radiotherapy was delivered in supine position by parallel opposing fields including the primary tumour, disease extension, and neck nodes. The study concluded that the loco-regional responses are analogous in Arm I and Arm 2, however Arm II had additional treatment allied toxicities and resulting from numerous of treatment breaks.
Background: Intracavitary brachytherapy plays a major role in management of cervical carcinoma. Assessment of dose received by OAR’s therefore becomes crucial for the estimation of radiation toxicities in high dose rate brachytherapy.Objective: The purpose of this study is to evaluate the role of in vivo dosimetry in HDR brachytherapy and to compare the actual doses delivered to OAR’s with those calculated during treatment planning.Materials and Methods: A total of 50 patients were treated with Microselectron HDR. Out of 50 patients, 26 were treated with a dose of 7 Gy and 24 with a dose of 9 Gy, prescribed to point A. Brachytherapy planning and evaluation of dose to the bladder and rectum was done on TPS & in vivo dosimetry was performed using portable MOSFET.Results: The calibration factors calculated for both the dosimeters are almost equal and are 0.984 cGy/mV and 1.0895 cGy/mV. For bladder, dose deviation was found to be within +/- 5% in 28 patients, +/- 5-10% in 14 patients, +/- 10-15% in 4 patients. The deviation between the TPS-calculated dose and the dose measured by MOSFET for rectum was within +/- 5% in 31 patients, +/- 5–10% in 8 patients, and +/- 10–15% in 7 patients.Conclusion: TPS calculated doses were slightly higher than that measured by MOSFET. The use of a small size of MOSFET dosimeter is an efficient method for accurately measuring doses in high-dose gradient fields typically seen in brachytherapy. Therefore, to reduce risk of large errors in the dose delivery, in vivo dosimetry can be done in addition to TPS computations.
Introduction: Cervical cancer continues to be a major public health problem affecting middle-aged women, particularly in less-resourced countries. External beam radiation therapy along with intra cavitary insertion has long been the treatment of choice for locally advanced (IIB-IVA) cervical cancer, but long-term successes are limited in terms of pelvic recurrence or distant metastasis. Outcome of low dose daily versus weekly versus three weekly Cisplatin concurrent with External beam radiotherapy in locally advanced cervical carcinoma was compared in this study.
Methods: A prospective cross sectional study was carried out in J K cancer institute, Kanpur. Total 60 patients of cervical cancer were randomized into 3 arms. Arm I, Arm II and Arm III received External beam radiotherapy concurrent with either daily (8mg/m2), weekly (40 mg/m2) or three weekly (100 mg/m2) Cisplatin respectively. External beam radiotherapy was given with a dose of 50 Gy / 25 # / 5 week / 2 field or 4 field. Patients were evaluated weekly during treatment and afterwards up to 1year. Results: Most of the patients were from fourth and fifth decade, low socioeconomic strata and illiterate. Majority of the cases belong to squamous cell carcinoma (96.6%) and stage III B (55%). Objective response in arm I was 80.0%, in arm II was 75.0% and in arm III was 60.0% respectively. Statistically significant difference was noted between arm III and Arm I (80%Vs60% p<0.05). Results were better in arm I as compare to arm II but not statistically significant. (80%Vs75% P>0.05)
Conclusions: This study showed that response was better in ARM I as compared to ARM III and best results was seen with Cisplatin concurrent daily with radiation.
Keywords: Cisplatin, concurrent chemotherapy, daily, weekly, three weekly, carcinoma cervix
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