Analysis of treatment outcome in cervix cancer patients treated with co-60 hdr brachytherapy: an institutional experience at tertiary care centre in north west india

Author: 
Shantanu Sharma, Shivangi Agrawal, R S Gothwal, Subhash Chand, and Sandeep Jain

Introduction: In India, cervical cancer accounts for almost 14% of all female cancer cases and second most common cancer in females. In past, Iridium-192 was widely used for high-dose rate brachytherapy but at present Co-60 source emerges as more popular radioactive source for HDR-BT with longer half life, similar geometric and dosimetric properties. This represents a significant advantage over HDR Co-60 source by reduction of resource sparing, quality assurance and workload.
Objective: To determine acute toxicity and response of HDR C0-60 brachytherapy in cancer cervix patients
Methods: Fifty histological confirmed FIGO stage IB-IVA, cervical cancer patients received 50Gy/25Fr EBRT with concurrent weekly cisplatin for 5 weeks and 21 Gy in 3 fractions of HDR brachytherapy with Co-60 source using modified Fletcher suite applicator. ICRU-38 was used for treatment planning and dose optimization and response & toxicities were assessed by RECIST version-1.1 & CTCAE respectively. A total 3 months of follow up post RT was taken in study.
Results: The median EQD2and BED tumor (EBRT+HDR ICBT) was 80 Gy & 95.7 Gy while BED bladder and BED rectum was 100 Gy and 102.64 Gy respectively. Complete response at 3 months of follow up was 84%. Diarrhea grade ≤ 2 was present in 54% patients and only one patients developed grade 3 diarrhea. Proctitis grade ≤ 2 was present in 54% patients. Vomiting grade ≤ 2 was present in 12% patients while grade 1 urinary frequency and urgency was noted in more than 40% patients. All results were comparable with previously published studies.
Conclusion: Co-60 as HDR brachytherapy source is tolerable and is economical for low resource settings.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2020. 23318.4620
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