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Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic
PURPOSE: Brachytherapy (BT) for cervix cancer was listed as a level I priority and reduced number of implants and multiple fractions were recommended during COVID-19 pandemic. We present early clinical outcome of this approach. METHODS AND MATERIALS: Patients treated with (chemo)radiotherapy and BT...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Brachytherapy Society. Published by Elsevier Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626438/ https://www.ncbi.nlm.nih.gov/pubmed/36585283 http://dx.doi.org/10.1016/j.brachy.2022.10.006 |
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author | Chopra, Supriya Mulani, Jaahid Mittal, Prachi Singh, Maneesh Shinde, Amruta Gurram, Lavanya Scaria, Libin Aravindakshan, Dheera Kohle, Satish Rane, Priyanka Ghadi, Yogesh Rath, Sushmita Ghosh, Jaya Gulia, Seema Gupta, Sudeep Kinhikar, Rajesh Laskar, Sarbani Agarwal, Jai Prakash |
author_facet | Chopra, Supriya Mulani, Jaahid Mittal, Prachi Singh, Maneesh Shinde, Amruta Gurram, Lavanya Scaria, Libin Aravindakshan, Dheera Kohle, Satish Rane, Priyanka Ghadi, Yogesh Rath, Sushmita Ghosh, Jaya Gulia, Seema Gupta, Sudeep Kinhikar, Rajesh Laskar, Sarbani Agarwal, Jai Prakash |
author_sort | Chopra, Supriya |
collection | PubMed |
description | PURPOSE: Brachytherapy (BT) for cervix cancer was listed as a level I priority and reduced number of implants and multiple fractions were recommended during COVID-19 pandemic. We present early clinical outcome of this approach. METHODS AND MATERIALS: Patients treated with (chemo)radiotherapy and BT with single implant and multiple fractions BT were included. Treatment protocol included 3−5 fractions of 5−8.5 Gy with an aim to achieve point A dose of 70 Gy EQD2(10Gy) (or HRCTV dose of >80 Gy EQD2(10Gy)) in those undergoing intracavitary (IC) and HRCTV dose >85 Gy EQD2 10Gy in patients undergoing Intracavitary-Interstitial (IC/IS) whereas maintaining bladder (B2cc), rectum (R2cc), sigmoid (S 2cc) doses of 90, 75, and 75 Gy EQD2(3Gy). Time to event analysis was used to report oncological endpoints. Toxicity was reported using crude proportions. RESULTS: From April 2020 to March, 2021, 64 patients with stage IB2-IV received single implant and multi-fraction BT after external radiation of 45 Gy/25 fractions/5 weeks. Only 76.7% (n = 49) received concurrent chemotherapy. Median overall treatment time (OTT) was 56 days (38−131 days). Overall, 62.5% (n = 40) patients received IC and 37.5% (n = 24) received IC+IS. The median HRCTV was 34.7 cc (IQR 25−41). Median (IQR) point A dose, HRCTV D90, B2cc, R2cc, and S2cc for those undergoing IC was 74 Gy (71−78), 80 Gy (73−84), 86 Gy (82−89), 70 Gy (65−74), 65 Gy (59−73) respectively. For the IC+IS cohort, HRCTV D90, B2cc, R2cc, and S2cc was 84 Gy (78−89 Gy), 89 Gy (86−92), 70 Gy (67−74), 68 Gy (59−76). At a median follow-up of 16 months (5−27) the 2-year local control, pelvic control, cause specific and overall survival was 88%, 85.3%, 92.2%, and 81.3% respectively. Late gastrointestinal and genitourinary grade ≥III toxicities were 14% and 1.5% each. CONCLUSIONS: Abbreviated BT outcomes are encouraging for oncological outcomes despite delays in overall treatment time and omission of chemotherapy. Further mature follow up is needed. |
format | Online Article Text |
id | pubmed-9626438 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | American Brachytherapy Society. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96264382022-11-02 Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic Chopra, Supriya Mulani, Jaahid Mittal, Prachi Singh, Maneesh Shinde, Amruta Gurram, Lavanya Scaria, Libin Aravindakshan, Dheera Kohle, Satish Rane, Priyanka Ghadi, Yogesh Rath, Sushmita Ghosh, Jaya Gulia, Seema Gupta, Sudeep Kinhikar, Rajesh Laskar, Sarbani Agarwal, Jai Prakash Brachytherapy Article PURPOSE: Brachytherapy (BT) for cervix cancer was listed as a level I priority and reduced number of implants and multiple fractions were recommended during COVID-19 pandemic. We present early clinical outcome of this approach. METHODS AND MATERIALS: Patients treated with (chemo)radiotherapy and BT with single implant and multiple fractions BT were included. Treatment protocol included 3−5 fractions of 5−8.5 Gy with an aim to achieve point A dose of 70 Gy EQD2(10Gy) (or HRCTV dose of >80 Gy EQD2(10Gy)) in those undergoing intracavitary (IC) and HRCTV dose >85 Gy EQD2 10Gy in patients undergoing Intracavitary-Interstitial (IC/IS) whereas maintaining bladder (B2cc), rectum (R2cc), sigmoid (S 2cc) doses of 90, 75, and 75 Gy EQD2(3Gy). Time to event analysis was used to report oncological endpoints. Toxicity was reported using crude proportions. RESULTS: From April 2020 to March, 2021, 64 patients with stage IB2-IV received single implant and multi-fraction BT after external radiation of 45 Gy/25 fractions/5 weeks. Only 76.7% (n = 49) received concurrent chemotherapy. Median overall treatment time (OTT) was 56 days (38−131 days). Overall, 62.5% (n = 40) patients received IC and 37.5% (n = 24) received IC+IS. The median HRCTV was 34.7 cc (IQR 25−41). Median (IQR) point A dose, HRCTV D90, B2cc, R2cc, and S2cc for those undergoing IC was 74 Gy (71−78), 80 Gy (73−84), 86 Gy (82−89), 70 Gy (65−74), 65 Gy (59−73) respectively. For the IC+IS cohort, HRCTV D90, B2cc, R2cc, and S2cc was 84 Gy (78−89 Gy), 89 Gy (86−92), 70 Gy (67−74), 68 Gy (59−76). At a median follow-up of 16 months (5−27) the 2-year local control, pelvic control, cause specific and overall survival was 88%, 85.3%, 92.2%, and 81.3% respectively. Late gastrointestinal and genitourinary grade ≥III toxicities were 14% and 1.5% each. CONCLUSIONS: Abbreviated BT outcomes are encouraging for oncological outcomes despite delays in overall treatment time and omission of chemotherapy. Further mature follow up is needed. American Brachytherapy Society. Published by Elsevier Inc. 2023 2022-11-02 /pmc/articles/PMC9626438/ /pubmed/36585283 http://dx.doi.org/10.1016/j.brachy.2022.10.006 Text en © 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Chopra, Supriya Mulani, Jaahid Mittal, Prachi Singh, Maneesh Shinde, Amruta Gurram, Lavanya Scaria, Libin Aravindakshan, Dheera Kohle, Satish Rane, Priyanka Ghadi, Yogesh Rath, Sushmita Ghosh, Jaya Gulia, Seema Gupta, Sudeep Kinhikar, Rajesh Laskar, Sarbani Agarwal, Jai Prakash Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic |
title | Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic |
title_full | Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic |
title_fullStr | Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic |
title_full_unstemmed | Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic |
title_short | Early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during COVID-19 pandemic |
title_sort | early outcomes of abbreviated multi-fractionated brachytherapy schedule for cervix cancer during covid-19 pandemic |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626438/ https://www.ncbi.nlm.nih.gov/pubmed/36585283 http://dx.doi.org/10.1016/j.brachy.2022.10.006 |
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