Palliative Split-Course pelvic radiotherapy for symptomatic cervical cancer

Abstract

Objective: Palliative pelvic RT effectively relieves significant health issues such as bleeding from the tumor, pain, discharge, or mass effect on the rectum genitourinary tract vessels and nerves in cervical cancer patients. There is no exact conclusion about an ideal palliative radiation treatment dose regimen. Thus we share the results of a commonly used split-course palliative pelvic RT regimen in our hospital. Material and Methods: For a retrospective study, 9 patients records treated between 2015 and 2019 were reviewed. The dose of prescribed irradiation for the target was 20Gy in 5 daily fractions. An additional 20Gy in 5 fractions was delivered after a 2-week time for recovery. Symptomatic improvement and treatment-related toxicity during and after RT were assessed from handwritten clinician reports. Results: Vast majority of patients enduring, and rapid symptomatic improvement was observed. Grade 3 to 5 treatment toxicity was not examined. Maximum acute toxicity was grade 1 GI or GU toxicity in 4 patients and G2 in two patients. Three patients had no acute side effects. All patients had complete symptom remission after treatment, one patient did not complete the second course of therapy due to deteriorating performance status, but local symptom relief was achieved. Conclusion: Split course regimen effectively improved symptoms without significant toxicity. The integrated 2-week break allowed doctors to assess patients for increased dose palliative radiation and balanced therapeutic benefits with possible adverse effects. This regimen is a reasonable strategy for patients who do not tolerate definitive treatment.