194P - A study of the treatment response of concomitant external beam radiotherapy (EBRT) and intracavitary brachytherapy in the management of locally advanced carcinoma of uterine cervix

Background

Uterine cervix cancer is especially frequent in Bangladesh. External beam radiotherapy (EBRT) and brachytherapy (BT) are effective treatments for cervical cancer.

Methods

This experimental investigation was done with histopathologically proven (squamous cell carcinoma) locally progressed carcinoma cervix with no history of prior therapy who came to the Department of Oncology, BSMMU; Department of Radiation Oncology NICRH for treatment. This research comprised 60 patients who met inclusion/exclusion criteria. Using a non-probability sampling approach, we separated the patients into two groups (30 in arm A and 30 in arm B). Arm-A had simultaneous EBRT and HDR-ICRT (EBRT = 50–50. 4 Gy/25–28 Fr, HDR 7 Gy in 3 Fr during the 3rd, 4th, and 5th weeks), although EBRT and weekly cisplatin (40 mg/m2) were not administered on the day of HDR-ICRT. Arm-B received EBRT and weekly cisplatin (40 mg/m2) followed by HDR-ICRT. Both groups were assessed weekly (general and systemic examination). All participants of both treatment modalities were followed up at the 6th and 12th week and at the 6th month following treatment to assess response and toxicities, and treatment success was reported as tumour size decrease (RECIST criteria and imaging tests) Symptom remission and cure may cause anaemia, neutropenia, thrombocytopenia, jaundice, renal failure, diarrhoea, nausea, and vomiting, according to the National Cancer Institute's “Common Terminology Criteria for Adverse Events, v.4.03” Comparing local tumor control and early complications at 6-month follow-up.

Results

Patients were 50±8.5 when diagnosed. Most patients are low-to-middle-class. 6 months following therapy, arm A had 86.6% full remission while arm B had 83.3%. Overall, 85% responded. Bladder and rectal, cutaneous, mild intestinal, and hematologic problems were well-managed. Three patients in arm A and two in arm B suffered grade II bladder toxicity, whereas only two in arm A developed rectal grade II toxicity. Arm B lacked rectal toxicity.

Conclusions

Concurrent ICBT and pelvic EBRT are similarly effective in addressing locally advanced carcinoma cervix with comparable toxicities and reduce total treatment time, allowing more patients to be treated each year.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Dhaka Medical College & Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.