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
304P - Survival outcomes and survival predictors in recurrent and metastatic head and neck squamous cell cancer (R/M-HNSCC) patients treated with chemotherapy (CT) plus cetuximab as first-line therapy in a real-world study
Presenter: Filipa Pontes
Session: Poster display session
Resources:
Abstract
305P - A retrospective study to evaluate patient characteristics for recurrent head and neck cancer after definitive treatment
Presenter: Tetsuro Wakasugi
Session: Poster display session
Resources:
Abstract
306P - Efficacy and safety of apatinib in heavily pretreated metastatic adenocarcinoma of the head and neck
Presenter: Lin Gui
Session: Poster display session
Resources:
Abstract
307P - Lacrimal gland tumours: Clinical and epidemiological patterns in the United States
Presenter: Mahmoud KhalafAllah
Session: Poster display session
Resources:
Abstract
308P - Dental prophylaxis and 5-fluorouracil related oral mucositis in head and neck cancer patients: A population-based cohort study
Presenter: Yi-Fang Huang
Session: Poster display session
Resources:
Abstract
309P - Evaluation of a pharmacist-led opioid de-escalation (PLODE) program after chemoradiotherapy completion in head and neck cancer patients
Presenter: Ai Horinouchi
Session: Poster display session
Resources:
Abstract
310P - Laser and PDT for the oral leukoplakia
Presenter: Sadykov Rasul
Session: Poster display session
Resources:
Abstract
311P - Incidence of thyroid carcinoma in the Philippines: A retrospective study from a tertiary university hospital
Presenter: Priscilla Caguioa
Session: Poster display session
Resources:
Abstract
312P - Oral health disparities among privileged and underprivileged tribes of south India - A study on precancerous oral lesions prevalence
Presenter: Shanavas Palliyal
Session: Poster display session
Resources:
Abstract
313P - Immunotherapy application for advanced cancers: One institution experiences since 2016 to 2019
Presenter: Jo Pai Chen
Session: Poster display session
Resources:
Abstract