Abstract
Background Chemoradiotherapy in addition to brachytherapy plays a major role in thetreatmentofpatientswithlocallyadvancedcarcinomacervix.However, Intracavitatorybrachytherapy(ICBT)isnotfeasibleinallpatientsforvariousreasons, and these are the patients considered for High dose rate Intestitial Brachytherapy (HDR-ISBT).Theaimofthisstudywastoreporttheoutcomeandtoxicityprofileof patients undergoing HDR- ISBT Methods Between January 2009 and December 2013, 103 patients with locally advanced carcinoma cervix (International Federation ofGynecologyand Obstetrics{FIGO}stageIIB-IVA),weretreatedwithexternalbeamradiotherapy (EBRT)of45to50Gyat1.8to2Gyperfractionover5to6weeks,alongwithorwithout concurrentchemotherapy(cisplatin).AllpatientsreceivedHDR-ISBTboostof3 fractions, 6 to 7 Gy per fraction after EBRT Results MajorityofthepatientsbelongedtoFIGOstageIII68/103(66.02%),stageIIB 31/103(30.1%)andonly4/103(3.88%)stageIVA.Themostcommonindicationfor HDRISBT was cervical os not negotiable56/103(54.36%), followed byresidual parametrialdisease33/103(32.03%),anatomynotfitforICBT10/103(9.70%),no documented reason 4/103(3.88%) The Median follow up was 37 months, the three yeardiseasefreesurvivalandoverallsurvivalare58.25%and61.1%respectively.Grade III/IV rectal toxicity was seen in 11/103(10.67%) patients and grade III/IV bladder toxicity was seen in 5/103(4.8%) patients. The response to EBRT was the only factor affecting the survival ofpatients in multivariate analysis. Conclusions Locally advanced cervical cancer patients in whom ICBT is not possible, chemoradiotherapy followed by HDR ISBT achieves good survival rates with acceptable toxicity. Legal entity responsible for the study S.D.Shamsundar Funding Selffunded Disclosure All authors have declared no conflicts ofinterest.
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