Dose at posterior-inferior border of symphysis point: A predictor for vaginal stricture in cervical cancer.
Brachytherapy
; 22(5): 616-622, 2023.
Article
en En
| MEDLINE
| ID: mdl-37286402
ABSTRACT
PURPOSE:
To study the effect of various dose-volume parameters on the severity of vaginal stricture (VS) and the correlation of the latter with the posterior-inferior border of symphysis (PIBS) points in locally advanced cervical cancer patients treated with concurrent chemoradiation and brachytherapy. METHODS AND MATERIALS A prospective study was done on 45 histologically proven locally advanced cervical cancer patients between January 2020 and March 2021. All of them were treated with concurrent chemoradiation with 6 MV photon linear accelerator to a dose of 45 Gy/25 fractions in 5 weeks. Twenty-three patients were treated with intracavitary brachytherapy with a dose of 7 Gy/fraction/week for three fractions. Twenty-two patients were treated with interstitial brachytherapy, with 6 Gy/fraction for four fractions, each fraction 6 h apart. Grading of VS was done as per Common Terminology Criteria for Adverse Events version 5.RESULTS:
The median followup was 21.5 months. About 37.8% of patients had VS with a median duration of 8.0 months (4.0-12 months). About 22.2% had Grade 1, 6.7% had Grade 2, and 8.9% had Grade 3 toxicity. Doses at PIBS and PIBS-2 points had no correlation with vaginal toxicity, however, the dose at PIBS+2 was significantly associated with VS (pâ¯=â¯0.004). The treated length of the vagina at the time of brachytherapy (pâ¯=â¯0.001), initial tumor volume (pâ¯=â¯0.009), and vaginal involvement after completion of external beam radiotherapy (EBRT) (pâ¯=â¯0.01) were also statistically significant with the development of VS of Grade 2 or more.CONCLUSIONS:
Dose at PIBSâ¯+â¯2, treated length of the vagina with brachytherapy, initial tumor volume, and post-EBRT vaginal involvement are strong predictors for the severity of VS.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Braquiterapia
/
Neoplasias del Cuello Uterino
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
Brachytherapy
Asunto de la revista:
RADIOTERAPIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
India