OUTCOME AND TOXICITY OF EXTENDED-FIELD INTENSITY MODULATED RADIOTHERAPY (EF-IMRT) IN LOCALLY ADVANCED CARCINOMA OF CERVIX
EXPERIENCE FROM TERTIARY CANCER CENTER.
Keywords:
Locally advanced,, Cervical cancer,, Extended field radiotherapy.Abstract
Abstract
Background: Whether to irradicate the para-aortic node prophylactically or not in locally advanced cervical carcinoma in the absence of para-aortic lymphadenopathy, the recommendation varies across guidelines. Extended field radiotherapy (EFRT) may improve overall survival (OS) by better local control of the paraaortic nodal region compared to pelvic RT alone, especially in patients unable to tolerate concurrent pelvic chemoradiotherapy. Aims and objectives: Extended field pelvic and paraaortic intensity-modulated radiotherapy (IMRT) in the treatment of locally advanced cervical carcinoma with common iliac lymphadenopathy, focusing on dosimetric parameters, toxicities, and treatment outcomes. Material and Methods: This was a single institutional retrospective study carried out in the radiotherapy department at NRSMCH, Kolkata. A total of 30 HPE-proven locally advanced cervical cancer patients treated with extended field IMRT were selected for this retrospective study. Results: Response assessment was done 12-16 weeks after completion of treatment and 26 patients (86%) had complete loco-regional responses and 4 patients had the local disease (14%). The two-year overall survival (OS) was 86%. The common toxicity was grade I small bowel toxicity (diarrhea), skin reactions, and Grade I neutropenia; seen in 78%, 63 %, and 58% of patients respectively. Another acute toxicity was grade I anemia seen in 35% of patients. The Common late toxicity was grade I lower GI (11%). Conclusions: EF-IMRT is a convenient, feasible, and effective treatment modality with minimal toxicities for target coverage and para-aortic nodal control.
Keywords: locally advanced, cervical cancer, Extended field radiotherapy.
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