307PD - Results of high dose rate interstitial- brachytherapy in the treatment of locally advanced carcinoma cervix: A single institution experience

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Gynaecological cancers
Topics Cervical Cancer
Surgical oncology
Presenter S D Shamsundar
Citation Annals of Oncology (2016) 27 (suppl_9): ix94-ix103. 10.1093/annonc/mdw585
Authors S.D. Shamsundar, K. Aradhana, R. Nanda, B. Thejaswini, G.V. Giri, A.S. Udaykrishna, H.B. Govardhan
  • Radiation Oncology, Kidwai Memorial Institute of Oncology, 560030 - Bangalore/IN

Abstract

Background

Chemoradiotherapy in addition to brachytherapy plays a major role in the treatment of patients with locally advanced carcinoma cervix. However, Intracavitatory brachytherapy (ICBT) is not feasible in all patients for various reasons, and these are the patients considered for High dose rate Intestitial Brachytherapy (HDR-ISBT). The aim of this study was to report the outcome and toxicity profile of patients undergoing HDR- ISBT

Methods

Between January 2009 and December 2013, 103 patients with locally advanced carcinoma cervix (International Federation of Gynecology and Obstetrics{FIGO} stage IIB-IVA), were treated with external beam radiotherapy (EBRT) of 45 to 50 Gy at 1.8 to 2 Gy per fraction over 5 to 6 weeks, along with or without concurrent chemotherapy (cisplatin). All patients received HDR-ISBT boost of 3 fractions, 6 to 7 Gy per fraction after EBRT

Results

Majority of the patients belonged to FIGO stage III 68/103(66.02%), stage IIB 31/103(30.1%) and only 4/103 (3.88%) stage IVA. The most common indication for HDR ISBT was cervical os not negotiable 56/103(54.36%), followed by residual parametrial disease 33/103(32.03%), anatomy not fit for ICBT 10/103(9.70%), no documented reason 4/103(3.88%) The Median follow up was 37 months, the three year disease free survival and overall survival are 58.25% and 61.1% respectively. Grade III/IV rectal toxicity was seen in 11/103(10.67%) patients and grade III/IV bladder toxicity was seen in 5/103(4.8%) patients. The response to EBRT was the only factor affecting the survival of patients in multivariate analysis.

Conclusions

Locally advanced cervical cancer patients in whom ICBT is not possible, chemoradiotherapy followed by HDR ISBT achieves good survival rates with acceptable toxicity.

Clinical trial indentification

none

Legal entity responsible for the study

S.D.Shamsundar

Funding

Self funded

Disclosure

All authors have declared no conflicts of interest.