ACUTE TOXICITY PROFILE OF CONCURRENT CHEMORADIATION IN CARCINOMA CERVIX WITH THE INTEGRATION OF BRACHYTHERAPY DURING EXTERNAL BEAM RADIATION THERAPY

Abstract

Background: Concurrent chemoradiation with weekly cisplatin is the treatment of choice in a case of carcinoma cervix. Prolonging treatment time is detrimental to disease control. When brachytherapy is scheduled during external beam radiation therapy (EBRT), treatment time can be shortened signicantly thereby improving local control. As the delivery of radiation with brachytherapy is uniform and spares normal tissues it reduces the acute toxicities. In this study, we aimed to study the acute toxicities associated with this unique scheduling of brachytherapy along with EBRT. Fifty patients with carcinoma cervix between stage IIA to IIIB treated at our institution with chemo-Methods: radiation were included in the study. Concurrent chemotherapy was delivered using weekly cisplatin (40mg/m2) for 5 cycles. EBRT was delivered using four eld box technique. HDR brachytherapy was introduced after 3rd week of EBRT. Brachytherapy was delivered in 3 fractions each 8.5Gy at the end of the 3rd, 4th, and 5th week. Acute RTOG toxicities were assessed during the treatment and one week post treatment. The median age of the study population is 45 years. Eighty four percent ofResults: patients received 4 or more cycles of concurrent chemotherapy, whereas 16% of patients received only 3 cycles of concurrent chemotherapy. Most common toxicity observed in the current study population is diarrhea followed by vomiting. Most toxicities are of RTOG grade 0 or 1 and none of the patients developed grade 4 toxicity. Only two patients developed grade 3 diarrhea and one patient developed grade 3 neutropenia. Integrating brachytherapy schedule along with EBRT decreasesConclusion: overall treatment time with an acceptable acute toxicity prole.