Abstract 5352
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 these patients was judged to exceed the coverage limit of intracavitary brachytherapy alone. 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 tumour specific dose escalation leading to improved survival outcomes without adding treatment related late morbidity. The procedure was more conformal with improved dosimetry and clinical outcomes.
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
4546 - Efficacy and toxicity of weekly carboplatin and paclitaxel as induction or palliative treatment in advanced esophageal cancer patients
Presenter: Femke de Man
Session: Poster Display session 2
Resources:
Abstract
5908 - Perioperative chemotherapy with Docetaxel, Oxaliplatin, Fluorouracil and Leucovorin (FLOT) versus Epirubicin, Platinum and Capecitabine or Flourouracil (EOX/ECF) in Resectable Gastric or Gastroesophageal Junction Adenocarcinoma- Safety and response data from India.
Presenter: Tanuj Chawla
Session: Poster Display session 2
Resources:
Abstract
937 - Phase II Study of Preoperative Radiotherapy Combined with S-1 plus Cisplatin in Clinically Resectable Type 4 or Large Type 3 Gastric Cancer: OGSG1205
Presenter: Shunji Endo
Session: Poster Display session 2
Resources:
Abstract
1119 - Observational Study of the Peritoneal Washing Cytology Positive Gastric Cancer without Gross Peritoneal Metastasis Underwent Radical D2 Gastrectomy.
Presenter: Jun Eul Hwang
Session: Poster Display session 2
Resources:
Abstract
3744 - Primary results of multicenter phase II study of neoadjuvant chemotherapy with S-1 and oxaliplatin for locally advanced gastric cancer (Neo G-SOX PII)
Presenter: Akira Miki
Session: Poster Display session 2
Resources:
Abstract
5091 - Multicenter Phase I/II Feasibility Study of Adjuvant Treatment with S-1 in Patients after R0-Resection of Adenocarcinoma of the Stomach and Esophagogastric Junction (GMBH-STO-0114)
Presenter: Kathrin Heinrich
Session: Poster Display session 2
Resources:
Abstract
2891 - A phase I study of Docetaxel/Oxaliplatin/S-1 (DOS) combination neoadjuvant chemotherapy for patients with locally advanced adenocarcinoma of the esophagogastric junction
Presenter: Kei Hosoda
Session: Poster Display session 2
Resources:
Abstract
2994 - Apatinib combined with docetaxel in second-line treatment of advanced gastric cancer: a prospective clinical study (Data updated)
Presenter: Mudan Yang
Session: Poster Display session 2
Resources:
Abstract
3000 - A multicenter phase II study of TAS-114 in combination with S-1 in patients with pre-treated advanced gastric cancer (EPOC1604)
Presenter: Daisuke Takahari
Session: Poster Display session 2
Resources:
Abstract
4653 - Impact of Pembrolizumab (pembro) Versus Paclitaxel on Health-Related Quality of Life (HRQoL) in Patients With Advanced Gastric or Gastroesophageal Junction (GEJ) Cancer That Has Progressed After First-Line Chemotherapy (KEYNOTE-061)
Presenter: Eric Van Cutsem
Session: Poster Display session 2
Resources:
Abstract