Can pure accelerated radiotherapy given as six fractions weekly be an option in locally advanced carcinoma cervix: Results of a prospective randomized phase III trial

Sharma, Mukesh; Revannasiddaiah, Swaroop; Gupta, Manish; Seam, Rajeev Kumar; Gupta, Manoj Kumar; Rastogi, Madhup

doi:10.4103/0973-1482.148676

Cited by 3 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By undergoing direct (ionizing) or indirect (through free radical attack) radiation action, DNA is exposed to basically two types of damage: gene mutation and lysis. [16][17][18][19] DNA lesions are the most biologically important because they can compromise vital processes such as cell replication and transcription. 20 The different lesions produced by radiation, if left unrepaired, can compromise important biological functions such as DNA transcription and replication, leading to cell death.…”

Section: Theoretical Basismentioning

confidence: 99%

“…This means that, out of every 100 patients, 60 will undergo radiotherapy in one of their evolutionary stages. 19,23 In recent times, the most significant development in the treatment of locally advanced cervical carcinoma has been the introduction of radiochemotherapy. However, there are some impediments to its administration, including elderly patients, patients with pre-existing diseases and patients who refuse chemotherapy.…”

Section: Radiotherapymentioning

confidence: 99%

“…There are also financial issues, such as the cost of chemotherapy and the cost of managing toxicities. 19 …”

Section: Radiotherapymentioning

confidence: 99%

“…Normal cells are also compromised, resulting in their death or in nuclear and cytoplasmic changes that may persist for many years. 19,29,32,33 Cervical smear is considered an excellent method of investigation in the follow--up of patients undergoing radiation therapy for cervical cancer. The finding of malignant cells that persist after treatment or that reappear soon after allows immediate clinical and/or surgical intervention before the onset of any symptoms.…”

Section: Post-radiotherapy Effects On Cellsmentioning

confidence: 99%

“…After this period, all malignant cells disappear, and an atrophic cytological pattern is established. 19,27,29,32,33 Cellular changes are related to both the acute and to the chronic phases following radiation therapy. It is not always easy to differentiate these changes from those of malignant cells.…”

Section: Post-radiotherapy Effects On Cellsmentioning

confidence: 99%

See 4 more Smart Citations

Cytopathologic evaluation of patients submitted to radiotherapy for uterine cervix cancer

Padilha

Araujo

Souza

2017

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

Summary Cervical cancer is an important public health problem. Pap smear is the leading strategy of screening programs for cervical cancer worldwide. However, delayed diagnosis leads to more aggressive and less effective treatments. Patients with uterine cervix malignancies who are referred for radiotherapy have advanced-stage disease, which results in high rates of locoregional recurrence. The use of radiotherapy as a treatment for cervical cancer causes morphological changes in neoplastic and non-neoplastic epithelial cells, as well as in stromal cells, which make it difficult to diagnose the residual lesion, resulting in a dilemma in cytopathological routine. Based on the difficulties of cytopathologic evaluation for the follow-up of patients treated with radiotherapy for cervical cancer, our objective was to describe the actinic cytopathic effects. Our paper was based on a structured review including the period from June 2015 to April 2016, aiming at an exploratory-descriptive study. Bibliographic investigations were carried out through selection and analysis of articles, list of authors and keywords, selection of new articles focused on the analysis of bibliographic references to previously selected documents, as well as textbooks of recognized merit. The most incident actinic cytopathological alterations as described in the literature are: cellular gigantism, nuclear and cytoplasmic vacuolization, dyskeratosis, bi- and multinucleated (B/M) cells, macro and multiple nucleoli, anisokaryosis, anisonucleolosis and nuclear pyknosis. To date, a protocol has not been established that can precisely differentiate the morphological characteristics between benign cells with actinic effects from recurrent malignant cells on post-radiotherapy smears.

show abstract

Section: Theoretical Basismentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

“…There are also financial issues, such as the cost of chemotherapy and the cost of managing toxicities. 19 …”

Section: Radiotherapymentioning

confidence: 99%

Section: Post-radiotherapy Effects On Cellsmentioning

confidence: 99%

Section: Post-radiotherapy Effects On Cellsmentioning

confidence: 99%

See 3 more Smart Citations

Cytopathologic evaluation of patients submitted to radiotherapy for uterine cervix cancer

Padilha

Araujo

Souza

2017

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

show abstract

Radiation therapy for gynecologic malignancies during the COVID-19 pandemic: International expert consensus recommendations

Elledge

Beriwal

Chargari

et al. 2020

Gynecologic Oncology

View full text Add to dashboard Cite

Objective To develop expert consensus recommendations regarding radiation therapy for gynecologic malignancies during the COVID-19 pandemic. Methods An international committee of ten experts in gynecologic radiation oncology convened to provide consensus recommendations for patients with gynecologic malignancies referred for radiation therapy. Treatment priority groups were established. A review of the relevant literature was performed and different clinical scenarios were categorized into three priority groups. For each stage and clinical scenario in cervical, endometrial, vulvar, vaginal and ovarian cancer, specific recommendations regarding dose, technique, and timing were provided by the panel. Results Expert review and discussion generated consensus recommendations to guide radiation oncologists treating gynecologic malignancies during the COVID-19 pandemic. Priority scales for cervical, endometrial, vulvar, vaginal, and ovarian cancers are presented. Both radical and palliative treatments are discussed. Management of COVID-19 positive patients is considered. Hypofractionated radiation therapy should be used when feasible and recommendations regarding radiation dose, timing, and technique have been provided for external beam and brachytherapy treatments. Concurrent chemotherapy may be limited in some countries, and consideration of radiation alone is recommended. Conclusions The expert consensus recommendations provide guidance for delivering radiation therapy during the COVID-19 pandemic. Specific recommendations have been provided for common clinical scenarios encountered in gynecologic radiation oncology with a focus on strategies to reduce patient and staff exposure to COVID-19.

show abstract

Toxicity and Treatment Outcome of Accelerated Fractionation Radiotherapy Versus Conventional Fractionated Concomitant Chemoradiation in Locally Advanced Cervical Carcinoma: A Prospective Study

Daripa

Banerjee²,

SADHYA³

et al. 2022

Asian J Pharm Clin Res

View full text Add to dashboard Cite

Objectives: The benefit of concurrent chemoradiation is often not achievable due to poor tolerance due to increased toxicity, which is a common problem in our setting, where a significant portion of carcinoma cervix patients presents at an elderly age, with medical comorbidities, and with poor performance status. In addition, many patients refuse chemotherapy. Accelerated radiation therapy remains one of the possible alternatives there. Hence, we would like to perform a prospective study to compare treatment results between Pure Accelerated Radiation versus Concomitant Chemoradiation in Locally Advanced Squamous Cell Carcinoma of Cervix. Methods: After the initial investigative work, a total of 62 histologically confirmed squamous cell carcinoma of cervix locally advanced stage (FIGO-stage IB2 to IVA.) with ECOG performance status 0–2 patients were randomized into two arms: Arm A (Study arm, n=30) – Patients received Six fractions per week of External Beam Radiotherapy without chemotherapy and Arm B (Control arm, n=32) patients received concurrent chemoradiation with Five fractions per week of radiation with Weekly Injection of Cisplatin at the dose of 40 mg/m2. Results: Overall response rates between the two arms were similar and statistically not significant (p=0.352). All acute late toxicities are similar in both arms except acute renal toxicity which is more in the control arm and the difference is statistically significant (p=0.005). Conclusions: In developing countries like India with limited treatment facilities, pure accelerated RT with brachytherapy, without concurrent chemotherapy, may be a good option and it can be viewed as an equally effective option for the elderly patients, the patients who refuse, those who have contraindications for chemotherapy, or have comorbidities. Further, multicenter, controlled, and Phase III trials will be needed to prove the benefit of the shortening overall treatment time and compare the efficacy with chemoradiation.

show abstract

Can pure accelerated radiotherapy given as six fractions weekly be an option in locally advanced carcinoma cervix: Results of a prospective randomized phase III trial

Cited by 3 publications

References 0 publications

Cytopathologic evaluation of patients submitted to radiotherapy for uterine cervix cancer

Cytopathologic evaluation of patients submitted to radiotherapy for uterine cervix cancer

Radiation therapy for gynecologic malignancies during the COVID-19 pandemic: International expert consensus recommendations

Toxicity and Treatment Outcome of Accelerated Fractionation Radiotherapy Versus Conventional Fractionated Concomitant Chemoradiation in Locally Advanced Cervical Carcinoma: A Prospective Study

Contact Info

Product

Resources

About