Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session

242P - Impact of combined interstitial and intracavitary brachytherapy in locally advanced cervical cancer: A survival and toxicity profile assessment

Date

23 Nov 2019

Session

Poster display session

Topics

Tumour Site

Cervical Cancer

Presenters

Vibhay Pareek

Citation

Annals of Oncology (2019) 30 (suppl_9): ix77-ix90. 10.1093/annonc/mdz426

Authors

V. Pareek1, R. Bhalavat2, M. Chandra2

Author affiliations

  • 1 Radiation Oncology, NCI, All India Institute of Medical Sciences, 124105 - Delhi/IN
  • 2 Radiation Oncology, Jupiter Hospital, 400601 - Thane/IN

Resources

Login to get immediate access to this content.

If you do not have an ESMO account, please create one for free.

Abstract 242P

Background

Advancements in role of imaging in brachytherapy in treatment of cervical cancers has seen further improvement in therapeutic ratio. We assessed the impact of combined interstitial and intracavitary brachytherapy in locally advanced cervical cancer in relation to survival outcomes and toxicity profile.

Methods

A total 125 patients, histopathologically diagnosed as cervical cancer and staged as per FIGO staging, were enrolled for the procedure. After completing external beam radiation therapy (Median dose 50Gy), patients were evaluated for brachytherapy which involved CT based hybrid interstitial-intracavitary brachytherapy using Iridium-192 source and a novel template to facilitate therapy. Parametrial extent of the disease in thesepatients was judged to exceed the coverage limit of intracavitary brachytherapy alone. ‘Manish Jupiter template’ was used for guidance of parametrial needles to perform high-dose-rate-brachytherapy. Clinical feasibility, treatment outcomes and toxicity profile were assessed. The patients were followed up as per the institution protocol.

Results

There were 57 patients (45.6%) in FIGO stage IIIB and 50 patients (40%) in stage IIB. The median EBRT dose was 50Gy and Brachytherapy dose received was 23Gy. The overall median EQD2 was 85Gy. After a median follow up of 30 months (Range 10 -50 months), local control rate was 95.2% and 11 patients (8.8%) developed distant metastases (9-Lung, 2-brain). Of the distant metastases, 7 were Stage IIIB and 4 had IIB disease. The median total treatment time was 69 days. No adverse events were caused by the procedure. Grade 2 and 3 rectal and bladder toxicities were 7.9% and 2.4% and 5.66% and 2.4% respectively. Disease free survival probability after 1 and 2 years was 94.1% and 93.53%. On multivariate analysis, stage of disease IIB, treatment duration less than 49 days and EQD2 of more than 85Gy were found to improve the rate of local recurrence and distant metastases.

Conclusions

Hybrid brachytherapy with the novel template has shown to improve the therapeutic ratio in LACC by enabling a tumourspecific dose escalation leading to improved survival outcomes without adding treatment related late morbidity.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Vibhay Pareek.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.