One thousand cases of cobalt-based high dose rate brachytherapy treated at a tertiary care center: A retrospective study.

PURPOSE: This is a study of our experience with Co-60 high dose rate brachytherapy (HDR BT) from a tertiary care center. MATERIALS AND METHODS: One thousand patients were treated with Cobalt-based HDR BT for more than 6 years. The practice of BT was analyzed for clinical outcome, physical, radiobiological, and technical aspects. RESULTS: Among those 1000 patients, 906 (90.6%) patients had gynecologic cancer, 29 (2.9%) patients had intraluminal BT, 63 (6.3%) hadhead &neck (2.1%), keloid (2.1%) and mold BT (2.1%), and 2 (0.2%) had sarcoma. Dose rate decreased by 48.9%, and treatment time increased from 9.33 to 18.27 min over 5 years. No patients treatment was abandoned because of machine-related problems. CONCLUSION: Cobalt-based HDR BT is preferable in terms of lesser source exchanges, relatively uniform treatment time, quality assurance requirement, and cost.

Predicting toxicity for head and neck cancer patients undergoing radiation therapy: an independent and external validation of MDASI-HN based nomogram.

AIM: We conducted a study to validate the MDASI-HN based nomogram, which is used to predict the acute toxicities in head and neck cancer patients undergoing radiation therapy with or without chemotherapy. BACKGROUND: Tolerance to radiation varies from patient to patient and also depends on various other factors like tumor volume, dose of radiation, chemotherapy. Predicting the toxicities allow us to identify potential candidates who are likely to have a higher toxicity and, in addition, evaluates the nomogram when done on an independent group of patients. MATERIALS AND METHODS: Sixty biopsy confirmed head and neck cancer patients undergoing radiation were the subjects of the study. The patients completed patient reported outcome instrument (PRO) MDASI-HN questionnaire at the beginning and at the fifth week of radiation. The baseline score obtained was used to obtain the predicted score using nomogram. The nomogram was also externally validated as per the TRIPOD guidelines. RESULTS: The mean baseline, predicted and score at the fifth week were 27.28 ± 11.04, 73.33 ± 15.51 and 82.62 ± 17.67, respectively, for all sub-sites. A positive, significant correlation (p < 0.01) between the predicted score and the score at the fifth week was seen across all sub sites such as Oral cavity (p = 0.05), Oropharynx (p = 0.02), Hypo pharynx (p = 0.02) and Larynx (p = 0.02). CONCLUSION: The MDASI-HN questionnaire based nomogram is simple, easily doable and takes into consideration the initial symptoms as well the treatment details; thereby, it is able to predict the toxicities accurately.