Short Course Brachytherapy in Locally Advanced Cervical Cancer; Safety and Response Rate

Area of Science:

• Oncology
• Radiation Oncology
• Gynecologic Oncology

Background:

• Overall treatment time (OTT) is crucial for local control in locally advanced cervical cancer treated with chemoradiation.
• Definitive chemoradiation typically involves External Beam Radiation Therapy (EBRT), Brachytherapy (BT), and chemotherapy.

Purpose of the Study:

• To evaluate the efficiency and safety of reducing OTT by shortening brachytherapy duration to one week compared to three weeks.
• To assess the impact of a shortened brachytherapy course on treatment response and toxicity.

Main Methods:

• A non-randomized, open-label, phase II clinical trial involving 49 cervical cancer patients.
• Intervention group received one week of brachytherapy; control group received three weeks.
• All patients received EBRT with Cisplatin, followed by brachytherapy to deliver 60 Gy EQD2 to IR-CTV and 85-90 Gy EQD2 to HR-CTV.

Main Results:

• Over 95% complete response in both groups (96.1% intervention vs. 95.6% control, P > 0.05).
• No significant difference in complete response rates or acute toxicity between the one-week and three-week brachytherapy groups.
• No treatment failures were observed during the follow-up period (minimum 6 months, median 10 months).

Conclusions:

• Short-course brachytherapy (one week) is non-inferior to the conventional course (three weeks) regarding response rates and side effects.
• Shortening brachytherapy duration is a viable strategy for reducing OTT in cervical cancer treatment.
• This approach may lead to decreased treatment costs and warrants further investigation in larger, phase 3 trials.