"Role of Twice Weekly HDR-Brachytherapy in Management of Carcinoma Of Uterine Cervix Experience of Rural Centre in India"

Sanjay Singh Chandel; Rajesh Singh Baghel

Authors

Sanjay Singh Chandel
Rajesh Singh Baghel

Keywords:

twice weekly HDR brachytherapy, paclitaxel, cervical carcinoma

Abstract

Aim and Objective : Study of safety and efficacy of twice weekly HDR brachytherapy, in management of cervical carcinoma. Background and purpose : HDR brachytherapy (HDR-ICBT) is integral part of treatment in cervical cancer treated with curative intent.HDRICBT should always fractionated, if brchytherapy started after external radiotherapy and once in a week application was done then there is prolongation of overall treatment time (OTT) which leads to of tumour repopulation leading to poor tumour control. To reduce repopulation, OTT should be shortened either by increasing dose per fraction or administering more fractions per week, first approach has more complications. So to decreases OTT twice weekly regimen should be prefer. This study aims to evaluate the effectiveness and safety of twice weekly HDR-ICBT Materials and Methods : Hundred patients with locally advanced (stages IIB to IVA according to FIGO classification) carcinoma of uterine cervix were enrolled, radiotherapy was conventionally administered: 50.4 Gy/28 fractions by external beam (whole pelvis) followed by HDR-ICBT, 4 fractions of 7 Gy each. Paclitaxel was administered on weekly basis at dose of 40 mgÃƒÆ'Ã†'Ã‚¢ÃƒÆ'Ã¢â‚¬¹Ãƒ¢Ã¢â€š¬Ã‚ ÃƒÆ'Ã‚¢Ãƒ¢Ã¢â‚¬Å¡Ã‚¬Ã‚¢m 2 during entire course of external beam radiotherapy as a radio sensitizer. Overall treatment time 50 days. Results : Treatment response was evaluated three months after the end of radiotherapy by means of clinical examination and ultrasonography. Complete Regression (CR) in 83%, partial response (PR) 14% and progressive disease 3%. At 26 months of median follow up 73 patients alive, 58 patients are disease free. Conclusion : The twice weekly HDRICBT regimen may improve the local control rate with low complications as well as reduced overall treatment time.

Downloads

How to Cite

"Role of Twice Weekly HDR-Brachytherapy in Management of Carcinoma Of Uterine Cervix Experience of Rural Centre in India". (2013). Global Journal of Medical Research, 13(14), 33-38. https://medicalresearchjournal.org/index.php/GJMR/article/view/

Download Citation

Author Biography

Sanjay Singh Chandel

Dr. Sanjay Singh Chandel is an Assistant Professor in the Department of Radiotherapy at G R Medical College, Gwalior, Madhya Pradesh, India. He has contributed to the field of radiation oncology, particularly in the management of carcinoma of the uterine cervix using twice-weekly HDR brachytherapy, as documented in his study from a rural centre in India. His research interests also extend to cooperative AI and Shannon-Neumann measures, reflecting a multidisciplinary approach. Dr. Chandel is dedicated to advancing medical science through both clinical practice and academic research.

References

(1997) National Institute of Health consensus Development Conference Statement on cervical Cancer.

(2000) Global cancer statistics. 55, 74-108.

Chen Chen M.D Phase I trial of Taxol as a radiation sensitizer in advanced cervical cancer. 67, 131.

I. Phase Phase I study with weekly cisplatin-paclitaxel and concurrent radiotherapy in patients with carcinoma of the cervix uteri. 2000, 455-459.

B. Monk, K. Tewari (2007) Monk BJ, Tewari KS: Invasive cervical cancer, in DiSaia PJ, Creasman WT (eds): Clinical Gynecologic Oncology (ed 7).

Huang H-J, HongJ-H Chang T_C, Chou Tseng C-J, Huang K-G (2003) Prognostic value of age and histologic type in neoadjuvant chemotherapy plus radical surgery for bulky (>=4 cm) stage IB and IIA cervical carcinoma. 13, 204-11.

Los Santos, J. Thomas, G. (2007) Anemia correction in malignancy management: threat or opportunity Gynecol Oncol 2007. 105, 517-529.

Waggoner SE, Darcy KM (2006) Association between cigarette smoking and prognosis in locally advanced cervical carcinoma treated with chemoradiation: A Gynecologic Oncology Group study. 103, 853-858.

Nordsmark M, LoncasterJ, Aquino-Parsons C, Chou SC (2006) The prognostic value of pimonidazole and tumor p02 in human cervix carcinomas after radiation therapy: A prospective international multicenter study. 80, 123-31.

J. Int (1991) Lanciano RM, Won M, Coia LR: Pretreatment and treatment factors associated with improved outcome in squamous cell carcinoma of the uterine cervix: A final report of the 1973 and 1978 patterns of care studies. 20, 667-676.

Fyles AW, Pintilie M (1995) Prognostic factors in patients with cervix cancer treated by radiation therapy: results of a multiple regression analysis. 35, 107-117.

Petereit DG, Sarkaria JN, Chappell R, Fowler JF, Hartmann TJ (1995) The adverse effect of treatment prolongation in cervical carcinoma. 32, 1301-1307.

Eifel PJ, Smith Thoms WW Jr, Morris M (1994) The relationship between brachytherapy dose and outcome in patient with bulky endocervical tumor treated with radiation alone. 28, 113-8.

Perez A (1983) Radiation therapy alone in the treatment of carcinoma of uterine cervix I. Analysis of tumor recurrence. 51(8), 1393-1402. https://doi.org/10.1002/1097-0142(19830415)51:8

Jacobs J. (1986) Short term persistence of carcinoma of uterine cervix after radiation. 57(5), 944. https://doi.org/10.1002/1097-0142(19860301)57:5

Eifel Morris M, Grigsby Lu J, Stevens Levenback C Pelvic radiation with concurrent chemotherapy compared with pelvicand para-aortic radiation for high-risk cervical cancer. 340, 1137-43.

(1999) Concurrent cisplatin-based chemoradiation improves progression free and overall survival in advanced cervical cancer: Results of a randomized Gynecologic Oncology Group study. 340, 1144-1153.

Whiteny (1999) Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stages IIB-IVA carcinoma of the cervix with negative Para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Group study. 17, 1339.

A. Cerrotta, G. Garden, R. Cavina, F. Raspagliesi, B. Stefanon, GarassinoI Concurrent radiotherapy and weekly paclitaxel for locallyadvanced or recurrent squamous cell carcinoma of the uterine cervix.A study with intensification of dose. 23, 115-119.

Kim K (2006) Efficacy of paclitaxel and carboplatin as a regimen for postoperative concurrent chemoradiotherapy of high risk uterine cervix cancer. 101(3), 398-402.

Rao G.G (2005) Phase I clinical trial of weekly paclitaxel, weekly carboplatin, and concurrent radiotherapy for primary cervical cancer. 96(1), 168-172.

J. Delaloye, P. Coucke, S. Pampallona, G. Peltecu, P. De Grandi (1991) Radiation therapy duration influences overall survival in patients with cervical carcinoma. 20, 667-676.

Anupam AbhijitMandal, Lalit Kumar Ashtana, Mohan Aggarwal (2007) Abhijit Mandal, Anupam Kumar Ashtana, Lalit Mohan Aggarwal, Clinical Significance of cumulative biological effective dose and overall treatment time in the treatment of carcinoma cervix. 32(2).

Y. Hama (2001) Carcinoma of the Uterine Cervix: Twiceversus Once-weekly High-Dose-Rate Brachytherapy. 219(1), 207-212. https://doi.org/10.1148/radiology.219.1.r01ap08207

J. Int (2000) Nag S, Erickson B, Thomadsen B: The American Brachytherapy Society recommendations for highdose-rate brachytherapy for carcinoma of the cervix. 48, 201-211.