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Individually customised parametrial boost for locally advanced cervical cancer: is 2D planned external beam radiotherapy useful?

Published online by Cambridge University Press:  09 August 2019

Aparna Gangopadhyay Open the ORCID record for Aparna Gangopadhyay [Opens in a new window]  and
Subrata Saha
Aparna Gangopadhyay*
Affiliation:
Department of Radiotherapy, Chittaranjan National Cancer Institute, Kolkata, India
Subrata Saha
Affiliation:
Department of Radiotherapy, Medical College Hospitals, Kolkata, India
*
Author for correspondence: Aparna Gangopadhyay, Department of Radiotherapy, Chittaranjan National Cancer Institute, 37, S.P. Mukherjee Road, Kolkata 700026, India. Tel: +91 9836386469. Fax: 0091 33 2541 0088. E-mail: mails7778@gmail.com
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Abstract

Aim:

Pelvic wall control and toxicity was retrospectively assessed in patients who received individually customised parametrial boost (PMB) for locally advanced cervical cancer with 2D planned external beam radiotherapy. Outcomes of a dose-escalated combined boost were also evaluated.

Materials and methods:

Toxicity and pelvic wall recurrence was evaluated over a median period of 24 months between two groups who received different pelvic wall doses. One group was randomised to receive either intracavitary brachytherapy (ICRT) with an external beam PMB using a customised midline shield, or a dose-escalated combined boost with interstitial brachytherapy (ISBT) and PMB. The comparator group received no PMB.

Results:

At 24 months, pelvic wall recurrence occurred in 2/112 and 40/130 with and without PMB, respectively (p < 0·000001). No significant difference in toxicity was noted between boost versus no-boost groups (p = 0·56). Combined ISBT/PMB dose escalation showed no significant difference in pelvic wall recurrence compared with PMB alone (p = 0·49).

Findings:

Individually customised 2D PMBs with 3D image-based ICRT was safe and improved pelvic wall control in locally advanced cervix cancer. Dose-escalated combined boosts offered no significant benefit over standard boost doses.

Keywords

3D image-based brachytherapyinterstitial brachytherapylocally advanced cervical cancerparametrial boost
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 3 , September 2020 , pp. 248 - 253
Copyright
© Cambridge University Press 2019

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