A prospective comparative study of concurrent versus sequential intracavitrary brachytherapy with external beam radiotherapy in cervical cancer

Author: 
Rakesh Gocher, Shantanu Sharma, Subhash C Bairwa, Kartick Rastogi, Pawan Jangir, R S Gothwal, Sandeep Jain and Shivani Gupta

Aim: To compare concurrent versus sequential Intracavitary brachytherapy with External Beam Radiotherapy in Cervical Cancer stage II B & III B in terms of acute reactions and treatment response.
Methods and Materials: Fifty patients of carcinoma cervix (FIGO- II B/IIIB) were randomly divided into two groups: the study group treated with concomitant EBRT and HDR-ICBT (EBRT = 50–50.4 Gy/25–28 Fr, HDR 7 Gy in 3 Fr during the 3rd, 4th, and 5th weeks), EBRT and weekly cisplatin were not given on the day of HDR-ICBT; and the control group treated with EBRT followed by HDR-ICBT and weekly cisplatin. Acute reactions and local disease response were compared after treatment and at 6-month follow-up by using RTOG 4 POINT scale and WHO criteria respectively.
Results: The response of treatment in both the groups was assessed by WHO criteria. Complete Response was seen in 80% patients of study group and 68% patients of control group. Partial Response was seen in 16% patients of study & 20% of control group. Stable disease was seen in 0% patients of study group and 8% patients of No patient of either group had progressive disease. Acute skin reactions and diarrhea and bladder toxicity were within acceptable range.
Conclusion: It is concluded that concurrent External beam irradiation with Intracavitary brachytherapy, was found to be a better treatment regimen for management of carcinoma cervix stage IIB to IIIB and lead to better local pelvic disease control with shorter overall treatment time than External beam irradiation followed by intracavitary brachytherapy. This was not statistically significant in the present study and results were encouraging

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DOI: 
http://dx.doi.org/10.24327/ijcar.2020.22192.4372
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