Evaluation of the Response of Concurrent High Dose Rate Intracavitary Brachytherapy with External Beam Radiotherapy in Management of Early Stage Carcinoma Cervix

Patidar, Arvind Kumar; Kumar, Harvindra Singh; Walke, Rahul V.; Hirapara, P.; Jakhar, Shankar Lal; Bardia, Megh Raj

doi:10.1007/s13224-012-0209-x

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…However, ABS additionally consist of caution that these recommendations are no alternative for clinical experience and need to be tested in a clinical setting. Numerous [14][15][16][17][18] studies used distinctive fractionation schedules in HDR-ICRT, however the doses of EBRT to the complete pelvis range in their research. Consequently, a simple evaluation of fraction size and total physical dose might also lead to the wrong interpretation of outcomes.…”

Section: Discussionmentioning

confidence: 99%

Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study

Khandelwal,

Sharma,

et al. 2024

Asian Pac J Cancer Care

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Background: Cervical cancer is the common cancer cause of death among women in developing countries. High Dose Rate (HDR) intracavitary brachytherapy that is given with or sequential after EBRT, is an integral component in the treatment of carcinoma of the cervix. In recent years, High Dose Rate (HDR) brachytherapy in combination with External Beam Radiotherapy (EBRT) has been popular in the management of carcinoma of the cervix. Objectives: To evaluate treatment response post 3 and 6 months after treatment completion and treatment-related toxicities during treatment in weekly v/s biweekly HDR intracavitary brachytherapy after concomitant chemoradiation in squamous cell carcinoma cervix patients. Methods: A total of 60 cervical cancer patients fulfilling the inclusion criteria were selected. Patients were randomly assigned to the weekly and Biweekly HDR ICBT using the chit-box method with replacement. Arm A (Study arm): 30 patients with concurrent EBRT (50 Gy/25 fractions with 2 Gy per fraction) with weekly cisplatin (35 mg/m2) followed by HDR-ICBT 5 Gy * 5 fractions biweekly after completion of EBRT. Arm B (Control arm): 30 patients with concurrent EBRT (50 Gy/25 fractions with 2 Gy per fraction) with weekly cisplatin (35 mg/ m2) followed by HDR - ICBT 7.5 Gy * 3 fractions weekly after completion of EBRT. Results: Patients were assessed at 3 and 6 months to determine the local disease response and the incidence of any toxicities assessed during the treatment. All responses were graded as either CR (complete response), PR (partial response), SD (stable disease), or PD (progressive disease). 30 patients were assessed for therapy response using the WHO criteria. At 3 months arm A showed 86% CR and arm B showed 90% CR. 2 patients in arm A and 1 patient in arm B had PR. In both arms 2 patients had progressive disease. At 6 months 1 patient in both arms who had progressive disease converted into partial response after taking post RT chemotherapy. Conclusions: To sum up, brachytherapy is a vital aspect of the process of treating cervical cancer. Several centers have experimented with various doses and fractionation regimes. Patients in the current trial reported no safety concerns or intolerability issues across any treatment protocol. Arm A had treatment completion before arm B with comparable disease response and toxicities. Therefore, the choice of treatment plan depends on the individual patient’s circumstances and the institution’s demands. nonetheless, longer follow-ups and a bigger patient sample are needed for a solid evaluation of disease response and toxicity.

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Section: Discussionmentioning

confidence: 99%

Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study

Khandelwal,

Sharma,

et al. 2024

Asian Pac J Cancer Care

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“…Though, they concluded that shorter treatment duration was associated with longer OS. Ways to cut short this overall treatment time have been tested in the literature, with some using: (I) interdigitated BCT, i.e., concomitant with external beam RT schedule (22), however, it provided similar results when compared to conventional schedule; (II using a lesser number of fractions, e.g., 18 Gy in 2 fractions (9 Gy per fraction). Patel et al (19) obtained better local control rates and DFS provided the application was favourable.…”

Section: Discussionmentioning

confidence: 99%

Five-year survival outcomes with two different high dose rate brachytherapy schedules used in the treatment of cervical carcinoma

Khan¹,

Hussain²,

Siddiqui³

et al. 2022

Ther Radiol Oncol

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Background: There is significant variation among different centres concerning total doses and doses per fraction of high dose rate (HDR) brachytherapy in carcinoma cervix management. The main aim of this study was to compare two different HDR brachytherapy schedules in terms of local disease-free survival (DFS) and overall survival (OS).Methods: In total, 472 patients with cervical carcinoma were treated with curative intent concurrent chemo-radiotherapy followed by HDR intracavitary brachytherapy comparing two schedules of 6.5 Gray (Gy) per fraction for 4 doses or 8 Gy per fraction for 3 doses prescribed at point A.Results: A total of 260 patients received 6.5 Gy for 4 fractions (arm A), while 212 received 8 Gy for 3 fractions (arm B). The majority of patients had stage 2b and 3b disease. Treatment was completed within 69±6 days in arm A while in arm B it was completed within 61±6 days. Five-year OS in stage 1b2 was 80% in arm A and 85% in arm B; in stage 2a, 90% and 83%; in stage 2b, 71% and 76%; in stage 3a, 60% and 50%; and in stage 3b, 56% and 63%, respectively. In stage 4a, none of the patients survived beyond 40 months.Conclusions: Our results establish the efficacy and safety of 8 Gy per fraction HDR brachytherapy dose in 3 applications for the treatment of cervical carcinoma. Moreover, we have reported the 5-year survival outcomes stage and sub-group-wise for cervical carcinoma patients treated at a tertiary care centre.

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“…However, ABS also includes a caution that these guidelines are no substitute for clinical experience and need to be tested in clinical setting. In the literature, various [13][14][15][16][17][18] studies compared different fractionation schedules in HDR ICRT, but the doses of EBRT to the whole pelvis differ widely in their studies. So, simple comparison of fraction size and total physical dose, may lead to incorrect interpretation of results.…”

Section: Discussionmentioning

confidence: 99%

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

Tiwari¹

2019

jmscr

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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.

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Evaluation of the Response of Concurrent High Dose Rate Intracavitary Brachytherapy with External Beam Radiotherapy in Management of Early Stage Carcinoma Cervix

Cited by 8 publications

References 13 publications

Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study

Compare Two Different Fractionated Regimes of HDR Intracavitary Brachytherapy after Concomitant Chemoradiation in Carcinoma Cervix: A Prospective Study

Five-year survival outcomes with two different high dose rate brachytherapy schedules used in the treatment of cervical carcinoma

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

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