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Published on: April 17, 2012
Hypofractionated radiotherapy in carcinoma cervix IIIB: Tata Memorial Hospital experience
M A Muckaden1, A N Budrukkar, H B Tongaonkar
1Dept. of Radiation Oncology, Tata Memorial Hospital, Mumbai 400 012, Maharashtra, India.
Purpose Of The Study:
To analyze the role of hypofractionated radiotherapy in advanced carcinoma of cervix.
Basic Procedure:
Medical records of 62 women with advanced carcinoma cervix III3 treated during 1994-1996 were reviewed. Patients were treated with standard pelvic portals to a total dose of 39Gy in 13 fractions over 17 days followed by intracavitary brachytherapy. Forty-eight patients completed the planned treatment and were considered suitable for analysis of late reactions and survival.
Main Findings:
The 5-year disease free survival was 59% and the overall survival was 50% at the mean follow up of 40 months. Twenty-one (44%) patients developed acute gastrointestinal toxicity of which 5 patients had grade III and one patient had grade IV reaction. Ten patients (21%) developed acute genitourinary complications, 13 patients (27%) had late rectal reactions and 10 patients (20%) had late bladder complications. Three patients had grade I, five had grade II and five had grade III late rectal toxicity.
Conclusion:
Survival in patients treated hypofractionated radiotherapy appears comparable to that of standard fractionation. The acute gastrointestinal and skin reactions were mainly grade I or grade II. Hypofractionated radiotherapy can certainly be considered in a select group of patients where the local disease is extensive and is unsuitable for conventional treatment.
