A Comparative Study between two different HDR Fractionation schedules of Intracavitary Brachytherapy in Carcinoma Cervix Stage-III

Abstract

Aim: To compare and analysis two high-dose-rate intracavitary brachytherapy schedule of 7.5Gy per fraction per for 3 fractions over 6Gy per fraction for 4 fractions in the treatment of carcinoma of uterine cervix. Materials and Methods: Total 50 patients with carcinoma of the uterine cervix (Stages III) were treated with External Beam Radiotherapy (EBRT) and High Dose Rate Intracavitary Brachytherapy (HDR-ICBT). These were randomized to arm A-6 Gy per fraction for 4 fractions and arm B -7.5Gy per fraction for 3 fractions. In both Arms 25 patients were included, out of those 1 patient from Arm Blost during follow up. Then follow up was done after 1yr, 2yr & 3yr to evaluate the Local control rate, disease-free survival and overall survival. Results: The median follow-up period in the study was 22 months for Arm A and 21 months for Arm B. In the Control Arm A, Local control rate, disease-free survival and overall survival were 84%, 84%and 92 %, respectively, while in the Study Arm B, were 87.50%, 87.50% and 91.66%, respectively (p value >0.05). Conclusion:In Indian context taking into account of increased hospital burden of locally advanced cancer cervix patients, HDR intracavitary brachytherapy schedule of 7.5 Gy per fraction 3 fractions is the preferable option over 6 Gy per fraction 4 fractions with regard to comparable, acute and late toxicity, loco-regional control, disease free survival and better patients compliance to lesser fractionation schedule.