Inter-institutional comparison of treatment practice for cervical cancer with special emphasis on brachytherapy.

Abstract:

Purpose:To compare the cervical cancer treatment outcome and toxicities between two different institutions. Material and methods:We analysed the clinical outcome of cervical cancer patients treated at two different centres from January 2015 to December 2016. Centre A treated 72 patients by external beam radiotherapy (EBRT) to a dose of 45 Gy in 25 fractions followed by intracavitary brachytherapy (ICBT) 6.5 Gy × 4 fractions and centre B treated 89 patients by EBRT to a dose of 50.4 Gy in 28 fractions followed by ICBT 9 Gy × 2 fractions. The local control, distant metastases and treatment toxicities were compared. Results:The median follow-up in centre A was 12 months and in centre B was 18 months. The median overall treatment time in centre A was 52 days and in centre B was 61 days. The mean equieffective doses in 2 Gy (EQD2) for high risk target volume (CTVHR) and point A in centre A were 84.59 and 64.5 Gy, respectively. The mean EQD2 for point A in centre B was 78.5 Gy. One patient out of 72 (1.38%) had local recurrence in centre A and five patients out of 89 (5.6%) had local recurrence in centre B. Local control in centre A was 98.6% and in centre B was 94.3%. The local recurrence rate was higher in centre B but it was not statistically significant (p = 0.15). One patient developed brain metastasis in centre B. One patient developed grade 3 proctitis in centre A. Conclusions:A high dose rate brachytherapy fractionation schedule of 6.5 Gy × 4 fractions over 2 days for CTVHR is associated with reduced overall treatment time, a slightly higher local control rate and lesser dose to OARs compared to 9 Gy × 2 fractions given one week apart to point A.

authors

Ravindran E,Kumar M,Gururajachar JM,Thangaraj R

doi

10.5114/jcb.2019.88582

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

423-427

issue

5

eissn

1689-832X

issn

2081-2841

pii

37937

journal_volume

11

pub_type

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