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Category: Volume 13 Issue 04 April 2025
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Title: Prospective Study to Compare Chemoradiation plus Concomitant weekly HDR ICRT with Sequential HDR ICRT in the management of Carcinoma Cervix

Authors: Poonam Gautam, S.N. Prasad, M.W. Raza

 DOI: https://dx.doi.org/10.18535/jmscr/v13i04.01

Abstract

Background: Cervical Cancer is among the most commonly diagnosed cancers in women worldwide. It is 4th most common cancer in women worldwide. HPV (Human Papilloma Virus) infection is the major risk factor for Cervical Cancer. Treatment of Early-stage Cervical Cancer - Stage IA₁, IA₂ → Surgery or ICRT Alone. Stage IB₁ → Surgery or EBRT + ICRT. Stage IB₂ / IIA → Surgery + Post op RT. Advanced stage Cervical Cancer - Stage IIB, III, IV → Conc. Chemoradiotherapy.

Objective: This study seeks a) To evaluate efficacy & toxicity of a concomitant weekly brachytherapy regimen of Carcinoma Cervix b) To compare locoregional response in two arms; two months after completion of treatment & at the end of six months of radiotherapy.

Materials & Methods: Forty-five patients of Ca. Cervix were enrolled who have not undergone surgery. They were randomized in two arms. Arm A received Radiotherapy 46 Gy / 23 # + Conc. Inj. Cisplatin weekly followed by HDR ICRT 7 Gy/fraction twice weekly for total 3 fractions. Arm B received Radiotherapy 46 Gy / 23 # + Conc. Inj. Cisplatin weekly along with Concomitant weekly HDR ICRT 7 Gy/fraction for total 3 fractions.

Results: 81.81% (18) in Arm A & 83.33% (15) in Arm B had complete response -18.18% patients (4) in Arm A & 16.67% (3) in Arm B had Partial Response - 2 months after Treatment Completion

Conclusion: Concomitant HDR ICRT Brachytherapy sessions along with EBRT & Conc. Cisplatin administration resulted in better Complete Response Rates, toxicity profile, shortened overall Treatment time, decreased hospital stay & can be considered as a reasonable alternative to sequential HDR ICRT.

Keywords: Bilateral Salpingo-oophorectomy, External Beam Radiotherapy, High Dose Rate, Intra Cavitary Radiotherapy, Overall Treatment time, Complete Response, Partial Response

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Corresponding Author

Poonam Gautam

Junior Resident, Department of Radiation Oncology, J.K. Cancer Institute, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India