Context:There is enough documented evidence to prove the benefits of early and appropriate initiation of education among children with cerebral palsy (CP).Aim:To find out the proportion of children with CP who are enrolled for some kind of formal education and to study the determinants of the same.Setting and Design:This cross sectional study was done among children, attending the special clinics at government medical college, Thiruvananthapuram.Materials and Methods:Children between 3 and 12 years of age diagnosed with CP were subjects for the study.Statistical Analysis Used:Enrollment for any form of formal education was the major outcome variable. The factors associated with initiation of formal education were tested using Chi-square test or Fischer's exact test. Independent association of each factor was evaluated through binary logistic Regression analysis.Results and Conclusions:The mean (SD) age of the children (n = 86) was 5.7 (2.3) years with forty-six (53.5%) of them being girls. Diplegia was the commonest limb abnormality found. Fifty-two (60.5%) children were undergoing some kind of schooling. Those children who were less dependent physically and those who had achieved better language development were regular school goers. After binary logistic regression the ability of a child to speak in sentences (P = 0.008) and ambulatory level of the child (P = 0.019) were factors which favored, whereas delay in attaining the adaptive developmental milestone of transferring objects from one hand to another (P = 0.014) was found to be detrimental for school enrollment.

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(OR50.628 p50.032 95%CI 0.41-0.961), D90 HR-CTV volumes #45 ml (OR50.57 p50.015 95%CI50.363-0.90), maximal tumour extensions from uterine cavity ! 2.5 cm measured at level 1 cm above cervical os (p50.009 95% CI50.299-0.842) and maximal tumor extension !2 cm at level 2 cm above cervical os (p50.003 95%CI 0.123-0.66). Vaginal extensions had adequate D90 HR-CTV doses coverage in 83.62%. Inadequate doses to vaginal tumour were more correlated with applicator types and depth of tumour thickness than location of vaginal extensions. Good tumor response at 3 months after treatment seems to relate with D90 HR-CTV dose O 80 Gy. Complete response rate were 66.7% (8/12) vs 82.7% (43/52) vs 82.8% (24/29) for cases with total HR-CTV D90 of ! 80 Gy vs 80-84 Gy vs O 85 Gy respectively. Grade3 or more GI and GU toxicity were not strongly correlated with GEC-ESTRO dose constraints. Grade 3 bladder complication were found in 2.63% (2/76) vs 5.9% (1/17), p5 0.441, for D2cc bladder dose of ! 90 vs O 90 Gy. Grade 3 GI complication were found in 4.17% (1/24) vs 1.44% (1/69), p50.882, for D2cc rectal dose of ! 75 vs O 75 Gy and 2% (1/49) vs 2.27% (1/44), p50.438, for D2cc sigmoid dose of ! 75 vs O 75 Gy respectively. This could be due to low rate of grade 3 toxicity and short follow up time. Conclusion: Intracavitary brachytherapy alone may be used for clinical tumor size # 4 cm, tumour size !5 cm from CT/MRI imaging contour, D90 HR CTV volumes # 45 ml, maximal tumour extension # 2.5 cm at level of 1 cm above cervical os and maximal tumor extension # 2 cm at level 2 cm above cervical os. Total D90 HR CTV !80 Gy was correlated with poor complete response rate at 3 months. Clinical vaginal examination and MRI to evaluate tumour before first time of brachytherapy session should be considered for the selection of 3D brachytherapy insertion; regular ICBT versus combined intracavitary and interstitial brachytherapy.