Tumor control after palliative hypofractionated, &quot;Quad-shot,&quot; external beam radiotherapy followed by brachytherapy: An effective approach in medically compromised and/or elderly patients with cervix cancer

Kiattikul, CL; Narayan, K; Bernshaw, D; Van Dyk, S; Tzovaras, A; Lin, MY

Tumor control after palliative hypofractionated, "Quad-shot," external beam radiotherapy followed by brachytherapy: An effective approach in medically compromised and/or elderly patients with cervix cancer

Author(s): Kiattikul, CL; Narayan, K; Bernshaw, D; Van Dyk, S; Tzovaras, A; Lin, MY;
Details: Publication Year 2022-03,Volume 18,Issue #1,Page 173-179
Journal Title: Journal of Cancer Research and Therapeutics
Publication Type: Research article
Abstract: CONTEXT: Cervix cancer is still a leading cause of death in developing countries. Concurrent chemoradiation (CCRT) over 5 weeks followed by brachytherapy is standard of care in locoregionally advanced cervix cancer. Such prolonged treatment may not be tolerated in medically compromised patients. High-dose interrupted hypofractionated Quad-Shot (QS) radiotherapy with brachytherapy treatment was well tolerated. AIMS: This study aims to assess the locoregional tumor control in cervix cancer patients who were treated with QS regimen. SETTINGS AND DESIGN: Retrospective. SUBJECTS AND METHODS: Newly diagnosed histologically confirmed cervix cancer patients who were unfit for conventional CCRT and who were treated with QS protocol between 1999 and 2016 were analyzed. Tumor stage, treatment, and follow-up details were retrieved from an ethics-approved prospective departmental database. STATISTICAL ANALYSIS USED: Descriptive statistics and Kaplan-Meier method were used for estimating survival. RESULTS: Thirty-six patients were available for analysis. The median age was 70.5 (32-92) years. Twenty-two of 36 (61.1%) patients had nodal disease while 33% of all patients had distant metastasis. Of 27 patients who died during follow-up, the local and pelvic control was 75% and 60%, respectively. The median overall survival and progression-free survival were 18.6 months. Grade 3-4 toxicity was observed (16%) in the bowel only. CONCLUSIONS: Hypofractionated QS radiotherapy with brachytherapy resulted in an overall 82.1% at least stable disease at the primary site. This treatment regimen was well tolerated and may be considered appropriate for patients who may not be suitable for conventional fully fractionated CCRT.
Keywords: Aged; *Brachytherapy/adverse effects/methods; Female; Humans; Neoplasm Staging; Prospective Studies; Radiotherapy Dosage; Retrospective Studies; *Uterine Cervical Neoplasms/pathology/radiotherapy; Cervical cancer; hypofractionated; palliative
Department(s): Radiation Oncology; Radiation Therapy
PubMed ID: 35381780
Publisher's Version: https://doi.org/10.4103/jcrt.JCRT_1346_20
Open Access at Publisher's Site: https://doi.org/10.4103/jcrt.JCRT_1346_20
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-12-20 02:39:29

Last Modified: 2024-12-20 02:40:52