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.
Resources from the same session
107P - The efficacy of adjuvant chemotherapy according to the risk classification of recurrence based on the systemic inflammatory markers in patients with colorectal cancer liver metastases
Presenter: Masatsune Shibutani
Session: Poster display session
Resources:
Abstract
108P - Influence of liver metastasis locations on overall survival in patients with colorectal cancer
Presenter: Takayuki Sone
Session: Poster display session
Resources:
Abstract
109P - 18F-FDG PET/CT textural features as predictors of outcomes in patients with primary advanced colorectal cancer
Presenter: Jing Yang
Session: Poster display session
Resources:
Abstract
110P - D3 lymph node dissection may be necessary in clinical stage I right colon cancer
Presenter: Woong Bae Ji
Session: Poster display session
Resources:
Abstract
111P - Is preoperative chemoradiotherapy necessary for all patients with upper rectal cancer: One center retrospective study
Presenter: Jasur Madyarov
Session: Poster display session
Resources:
Abstract
112P - A retrospective analysis of the association between perioperative, post adjuvant carcinoembryonic antigen level and prognosis in stage III colorectal cancer
Presenter: Ryotaro Kozuki
Session: Poster display session
Resources:
Abstract
113P - Dicer contributes to chemoresistance in colorectal cancer via regulating a set of miRNAs and their downstream mRNAs
Presenter: Liang-Yi Hung
Session: Poster display session
Resources:
Abstract
114P - Efficacy and safety of the combination of bevacizumab with raltitrexed-based chemotherapy as second-line therapy in patients with metastatic colorectal cancer (mCRC): An interim analysis of a multicenter phase II trial
Presenter: Jun Zhu
Session: Poster display session
Resources:
Abstract
115P - Expression of Ki-67 as a prognostic factor in patients with colorectal cancer
Presenter: Kuantkan Zhabagin
Session: Poster display session
Resources:
Abstract
116P - Clinical significance and converionrate relevance of RAS genetic mutation analysis for unresectable colorectal liver metastases: A single-center retrospective study
Presenter: Meiling Ji
Session: Poster display session
Resources:
Abstract