Cargando…

Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India

PURPOSE: We aimed to assess the toxicity profile and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with a combination of image-guided intensity-modulated radiation therapy (IG-IMRT) and image-guided brachytherapy (IGBT). MATERIAL AND METHODS: 25 LACC patients were...

Descripción completa

Detalles Bibliográficos
Autores principales: Mishra, Vachaspati Kumar, Rastogi, Madhup, Gandhi, Ajeet Kumar, Khurana, Rohini, Hadi, Rahat, Sapru, Shantanu, Mishra, Surendra Prasad, Srivastava, Anoop Kumar, Singh, Neetu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669915/
https://www.ncbi.nlm.nih.gov/pubmed/38026079
http://dx.doi.org/10.5114/jcb.2023.132553
_version_ 1785139803645280256
author Mishra, Vachaspati Kumar
Rastogi, Madhup
Gandhi, Ajeet Kumar
Khurana, Rohini
Hadi, Rahat
Sapru, Shantanu
Mishra, Surendra Prasad
Srivastava, Anoop Kumar
Singh, Neetu
author_facet Mishra, Vachaspati Kumar
Rastogi, Madhup
Gandhi, Ajeet Kumar
Khurana, Rohini
Hadi, Rahat
Sapru, Shantanu
Mishra, Surendra Prasad
Srivastava, Anoop Kumar
Singh, Neetu
author_sort Mishra, Vachaspati Kumar
collection PubMed
description PURPOSE: We aimed to assess the toxicity profile and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with a combination of image-guided intensity-modulated radiation therapy (IG-IMRT) and image-guided brachytherapy (IGBT). MATERIAL AND METHODS: 25 LACC patients were recruited in this single-arm prospective study. Whole pelvis IG-IMRT was delivered (45 Gy with simultaneously integrated nodal boost of 55 Gy in 25 fractions), with concurrent weekly cisplatin (40 mg/m(2)). Patients received IGBT of 7 Gy each in 4 fractions to high-risk clinical target volume (HR-CTV). First fraction was done under MRI, and subsequent fractions were performed under CT guidance. Primary endpoint was acute toxicity, and secondary endpoints were 2-year loco-regional control and late toxicity. RESULTS: The median age was 52 years, and FIGO 2018 stage distribution was IIA2, IIB, IIIB, and IIIC1 in 12%, 40%, 20%, and 28% patients, respectively. All patients received concurrent chemotherapy with median number of 5 cycles (range, 4-5 cycles). Grade 1 and 2 diarrhea, and grade 1 cystitis was reported in 4 (16%), 3 (12%), and 2 (8%) patients, respectively. Grade 1 and 2 anemia, and grade 1 and 2 dermatitis were observed in 3 (12%) and 2 (8%), and 3 (12%) and 3 (12%) patients, respectively. No patient reported grade 3-4 acute toxicity. At median follow-up of 29.5 months (range, 25-37 months), late grade 1 bladder toxicity was observed in 1 (4%) patient. Loco-regional control at 1 and 2 years were 96% and 92%, respectively. CONCLUSIONS: The combination of IG-IMRT and IGBT yielded excellent outcomes in terms of acute toxicity and loco-regional control.
format Online
Article
Text
id pubmed-10669915
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Termedia Publishing House
record_format MEDLINE/PubMed
spelling pubmed-106699152023-10-01 Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India Mishra, Vachaspati Kumar Rastogi, Madhup Gandhi, Ajeet Kumar Khurana, Rohini Hadi, Rahat Sapru, Shantanu Mishra, Surendra Prasad Srivastava, Anoop Kumar Singh, Neetu J Contemp Brachytherapy Original Paper PURPOSE: We aimed to assess the toxicity profile and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with a combination of image-guided intensity-modulated radiation therapy (IG-IMRT) and image-guided brachytherapy (IGBT). MATERIAL AND METHODS: 25 LACC patients were recruited in this single-arm prospective study. Whole pelvis IG-IMRT was delivered (45 Gy with simultaneously integrated nodal boost of 55 Gy in 25 fractions), with concurrent weekly cisplatin (40 mg/m(2)). Patients received IGBT of 7 Gy each in 4 fractions to high-risk clinical target volume (HR-CTV). First fraction was done under MRI, and subsequent fractions were performed under CT guidance. Primary endpoint was acute toxicity, and secondary endpoints were 2-year loco-regional control and late toxicity. RESULTS: The median age was 52 years, and FIGO 2018 stage distribution was IIA2, IIB, IIIB, and IIIC1 in 12%, 40%, 20%, and 28% patients, respectively. All patients received concurrent chemotherapy with median number of 5 cycles (range, 4-5 cycles). Grade 1 and 2 diarrhea, and grade 1 cystitis was reported in 4 (16%), 3 (12%), and 2 (8%) patients, respectively. Grade 1 and 2 anemia, and grade 1 and 2 dermatitis were observed in 3 (12%) and 2 (8%), and 3 (12%) and 3 (12%) patients, respectively. No patient reported grade 3-4 acute toxicity. At median follow-up of 29.5 months (range, 25-37 months), late grade 1 bladder toxicity was observed in 1 (4%) patient. Loco-regional control at 1 and 2 years were 96% and 92%, respectively. CONCLUSIONS: The combination of IG-IMRT and IGBT yielded excellent outcomes in terms of acute toxicity and loco-regional control. Termedia Publishing House 2023-10-30 2023-10 /pmc/articles/PMC10669915/ /pubmed/38026079 http://dx.doi.org/10.5114/jcb.2023.132553 Text en Copyright © 2023 Termedia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/ (https://creativecommons.org/licenses/by-nc-sa/4.0/) )
spellingShingle Original Paper
Mishra, Vachaspati Kumar
Rastogi, Madhup
Gandhi, Ajeet Kumar
Khurana, Rohini
Hadi, Rahat
Sapru, Shantanu
Mishra, Surendra Prasad
Srivastava, Anoop Kumar
Singh, Neetu
Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India
title Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India
title_full Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India
title_fullStr Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India
title_full_unstemmed Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India
title_short Combination of image-guided IMRT and IGBT in locally advanced carcinoma cervix: Prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in India
title_sort combination of image-guided imrt and igbt in locally advanced carcinoma cervix: prospective evaluation of toxicities and clinical outcomes from a tertiary cancer center in india
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669915/
https://www.ncbi.nlm.nih.gov/pubmed/38026079
http://dx.doi.org/10.5114/jcb.2023.132553
work_keys_str_mv AT mishravachaspatikumar combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT rastogimadhup combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT gandhiajeetkumar combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT khuranarohini combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT hadirahat combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT saprushantanu combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT mishrasurendraprasad combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT srivastavaanoopkumar combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia
AT singhneetu combinationofimageguidedimrtandigbtinlocallyadvancedcarcinomacervixprospectiveevaluationoftoxicitiesandclinicaloutcomesfromatertiarycancercenterinindia