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
117P - Short-term and long-term outcomes of hepatectomy combined with intraoperative radiofrequency ablation for multiple colorectal liver metastases: A propensity score matching study
Presenter: Wenbai Huang
Session: Poster display session
Resources:
Abstract
119P - The impacts of dose-time-fractionation schedules on pathological complete response rate (pCR) and local recurrence (LR)
Presenter: Fu Jin
Session: Poster display session
Resources:
Abstract
120P - Platelet to lymphocyte ratio is associated with tumour localization and outcomes in patients with metastatic colorectal cancer
Presenter: Ahmet Bilici
Session: Poster display session
Resources:
Abstract
121P - Meta-analysis of three-dimensional versus two-dimensional laparoscopic surgery for rectal cancer
Presenter: Laiyuan Li
Session: Poster display session
Resources:
Abstract
127P - Outcomes based on albumin‐bilirubin (ALBI) grade in the phase III CELESTIAL trial of cabozantinib versus placebo in patients with advanced hepatocellular carcinoma (HCC)
Presenter: Stephen Chan
Session: Poster display session
Resources:
Abstract
128P - Tislelizumab in combination with chemotherapy for Chinese patients (Pts) with gastric/gastroesophageal junction cancer (GC/GEJC) or esophageal squamous cell carcinoma (ESCC)
Presenter: Yuxian Bai
Session: Poster display session
Resources:
Abstract
129P - Monitoring patient-specific mutation in ctDNA and CTC for tumour response evaluation after neoadjuvant chemotherapy in advanced gastric adenocarcinoma (NCT03425058)
Presenter: Tao Fu
Session: Poster display session
Resources:
Abstract
130P - Development of a liver cancer risk prediction model for the general population in china: A potential tool for screening
Presenter: Xiaoshuang Feng
Session: Poster display session
Resources:
Abstract
131P - Cabozantinib in Asian patients with hepatocellular carcinoma and other solid tumours: Population pharmacokinetics analysis
Presenter: Chih-Hung Hsu
Session: Poster display session
Resources:
Abstract
132P - Liposomal irinotecan (nal-IRI) plus 5-fluorouracil/levoleucovorin (5 FU/LV) vs 5-FU/LV in Japanese patients (pts) with gemcitabine-refractory metastatic pancreatic cancer (mPAC)
Presenter: Tatsuya Ioka
Session: Poster display session
Resources:
Abstract