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
4732 - Progesterone Receptor Isoform Ratio Dictates Antiprogestins/Progestins Effects on Metastatic Breast Cancer Models
Presenter: Maria Abascal
Session: Poster Display session 2
Resources:
Abstract
5737 - PAM50 and CGH-array genomic characterization of HER2-Equivocal Breast Cancers defined by the 2018 ASCO/CAP recommendations.
Presenter: Carine Ngo
Session: Poster Display session 2
Resources:
Abstract
1096 - OncotypeDX® predictive nomogram for recurrence score output: a machine learning system based on quantitative immunochemistry analysis - ADAPTED01
Presenter: Fabio Marazzi
Session: Poster Display session 2
Resources:
Abstract
5426 - Geriatric parameters predict both disease-related and patient-reported outcomes in older patients with breast cancer
Presenter: Willeke van der Plas-Krijgsman
Session: Poster Display session 2
Resources:
Abstract
5865 - Patients with a 21-gene assay in South East London differ from the TAILORx trial population
Presenter: Charalampos Gousis
Session: Poster Display session 2
Resources:
Abstract
1312 - Predictive tools in adjuvant breast cancer – what is the standard of evidence supporting their utility? A literature review examining validation of Adjuvant!, Cancermath and NHS Predict
Presenter: Alice Loft
Session: Poster Display session 2
Resources:
Abstract
2445 - Oncologic outcome of invasive lobular carcinoma: Is it different from that of invasive ductal carcinoma?
Presenter: Hee Jun Choi
Session: Poster Display session 2
Resources:
Abstract
2476 - Pathologic response and survival efficacy in patients with initial nodal involvement after neoadjuvant chemotherapy in early breast cancer
Presenter: SERAFIN MORALES Murillo
Session: Poster Display session 2
Resources:
Abstract
3761 - Chemotherapy-induced amenorrhea: prognostic impact on premenopausal Egyptian patients with breast cancer
Presenter: Khaled Abdel Karim
Session: Poster Display session 2
Resources:
Abstract
4687 - Predicting the presence of breast cancer using circulating small RNA in the serum
Presenter: Yumiko Koi
Session: Poster Display session 2
Resources:
Abstract