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
164P - Multi-centered phase II trial of weekly 5-FU plus l-LV regimen as salvage line chemotherapy for oral fluorouracil resistant advanced gastric cancer (HGCSG1502)
Presenter: Yusuke Sasaki
Session: Poster display session
Resources:
Abstract
165P - Lenvatinib treatment for advanced hepatocellular carcinoma: The relationship between efficacy and safety
Presenter: Takayoshi Oikawa
Session: Poster display session
Resources:
Abstract
166P - The comparison between UGT1A1 single heterozygous and wild type regarding the clinical outcomes of fixed dose irinotecan monotherapy for advanced gastric cancer: Multicenter retrospective study
Presenter: Takahide Sasaki
Session: Poster display session
Resources:
Abstract
167P - Prognostic impact of the C-reactive protein/albumin ratio in advanced pancreatic cancer treated with GEM plus nab-PTX or FOLFIRINOX: Based on the results of a multicenter retrospective study (the NAPOLEON study)
Presenter: Akitaka Makiyama
Session: Poster display session
Resources:
Abstract
168P - A retrospective multicenter study evaluating the efficacy and safety of irinotecan in patients with advanced gastric cancer: Analysis of Glasgow Prognostic Score (GPS)
Presenter: Takuya Honda
Session: Poster display session
Resources:
Abstract
169P - M-phase phosphoprotein 8 promotes gastric cancer growth and metastasis via p53/Bcl-2 and EMT-related signalling pathways
Presenter: Yizhuo Wang
Session: Poster display session
Resources:
Abstract
170P - Surgery alone versus surgery combined with Chemotherapy: Survival patterns among patients with fibrolamellar hepatocellular carcinoma
Presenter: Yasmine Ashraf
Session: Poster display session
Resources:
Abstract
171P - The clinical value of prognostic nutritional index in patients with anastomotic leakage after minimally invasive esophagectomy
Presenter: Yan Wang
Session: Poster display session
Resources:
Abstract
172P - Preoperative neutrophil‐to‐lymphocyte ratio (NLR) predicts recurrence after surgery in patient with pancreatic neuroendocrine neoplasm (PanNEN)
Presenter: Takayuki Miura
Session: Poster display session
Resources:
Abstract
173P - Cancer stem-like phenotypes including immune surveillance and its responsible genes in induced liver cancer stem-like cells
Presenter: Ryouichi Tsunedomi
Session: Poster display session
Resources:
Abstract