Abstract:
Background: Brachytherapy plays a pivotal role as a part of the cervical cancer management for its ability to deliver high dose to the tumour while reducing the dose to the surrounding critical organs. Over the last few years, the use of 3D image based brachytherapy has been revolutionized. In 2005, recommendations for 3D image based brachytherapy were developed by Groupe Europeen de Curietherapie of the European Society for Therapeutic Radiology and Oncology (GECESTRO) has now become standard. Vienna group and EMBRACE study group have reported a promising clinical outcome of patients treated with MR imageguided adaptive brachytherapy with excellent local control rates. However there is paucity of Indian data on MRI volume based brachytherapy in management of cervical cancer, thereof the study was undertaken to know the utility of GECESTRO recommendations in our settings.
Aims: 1.To assess the tumour response, local control and toxicities treated with MR based brachytherapy in cervical cancer. 2.To analyse outcomes of pre-defined good, moderate and poor responders following Concurrent Chemo-EBRT.
Materials and Methods: A study of 70 biopsy proven cervical cancer patients with stage IB2-IVA was recruited at Vydehi Hospital, Bangalore. All the patients have undergone EBRT to a dose of 45-50Gy in conventional fractionation with concurrent weekly chemotherapy followed by 3-5fractions of brachytherapy with 5-7Gy/fr and treatment duration ≤8weeks. A pre-EBRT MRI was taken, along with a CT simulation. On the first fraction of BT, a MRI scan is taken along with the BT applicator (MRI-BT) and on subsequent sittings; CT simulation is done which is fused with MRI-BT. The GTV, HR-CTV and OARs were delineated and planned according to GEC-ESTRO recommendations. Patients were followed up 6weeks after completion of treatment, then every 3 monthly for assessment local control and toxicity.
Results and Conclusions: will be presented during the conference.
