Toxicity outcome of concurrent teletherapy and brachytherapy compared with teletherapy followed by brachytherapy in locally advanced carcinoma cervix

Background: Teletherapy and intracavitary brachytherapy are definitive treatment modalities for stages IIB to IVA cervical carcinoma. Globally, it is the second most common cancer among female. Majority of patients attend the hospital with locally advanced stage due to less screening facility and social stigma.Methods: This quasi-experimental study was conducted from January 2019 to June 2020 with a total of 76 patients. The patients were equally divided into two groups: A and B after obtaining their informed written consent.Results: Final follow up was given after completion of treatment at 24 weeks. Patients in both groups developed grade 1 gastrointestinal and genitourinary toxicities (10.5% versus 13.1%, 13.1% versus 15.7% in group A and B respectively). Two patients in group A and three patients in group B developed grade 2 gastrointestinal toxicities. In genitourinary toxicities, grade 2 toxicities were observed in two patients of group A and four patients of group B, (p>0.05). None developed grade 3 and 4 gastrointestinal and genitourinary toxicities. There were no statistically significant variations in treatment related toxicities between the two groups.Conclusions: Both gastrointestinal, genitourinary toxicities were comparable between two groups. The toxicities were acceptable and well tolerated.

Comparison of dosimetric parameters between intensity modulated and three-dimensional conformal radiotherapy planning for adjuvant therapy of gastric cancer

Background: Adjuvant chemoradiotherapy is the standard treatment for gastric carcinoma, but the optimal radiation modality remains uncertain. This study aimed to compare intensity-modulated radiotherapy (IMRT) and three-dimensional conformal radiotherapy (3D-CRT) in terms of dosimetry for adjuvant gastric cancer treatment. Methods: 21 patients with stage IIB-IIIC gastric cancer, treated between January and June 2021, underwent surgery followed by adjuvant chemoradiation with both IMRT and 3D-CRT plans. Dosimetric parameters were calculated for the planned target volume (PTV) and organs at risk (OAR). Results: Both IMRT and 3D-CRT provided comparable PTV coverage. However, IMRT significantly improved kidney sparing, reducing the mean V20 value by 23% (p=0.01) for the right kidney and 26% (p=0.02) for the left kidney compared to 3D-CRT. IMRT also decreased the mean irradiated volume for both kidneys and the liver, as well as the V30 value for the liver, although these differences were not statistically significant. The dosimetric parameters for the spinal cord were comparable between IMRT and 3D-CRT plans. Conclusions: IMRT demonstrated better kidney sparing compared to 3D-CRT in adjuvant radiotherapy for gastric cancer, while PTV coverage was similar. Long-term follow-up is necessary to assess clinical outcomes and local recurrence rates for both treatment plans

Association of clinico-epidemiological features with locally advanced stage of cervical cancer patients presenting at Bangabandhu Sheikh Mujib Medical University, Bangladesh

Cervical cancer is one of the most prevalent gynecological cancers in women in Bangladesh. The objective of this study was to assess the clincoepidemiological association with the histology of locally advanced cervical cancer. We have done this observational study in the department of Clinical Oncology at Bangabandhu Sheikh Mujib Medical University from July to December 2019. Sixty-six biopsy-proven locally advanced (stage IIB to IVA) squamous cell carcinoma of uterine cervix were included in this study. The mean age of patients at diagnosis was 48.5 (±8.6) years. Commonly observed epidemiological characteristics of locally advanced carcinoma cervix were illiteracy (46.9%), oral contraceptive use (62.1%), multi para (78.7%) and early marriage (74.2%). Most frequent clinical presentation was post-coital bleeding (37.87%). Most patients presented in stage IIB (65.1%). The association of the stages of the disease with age, parity, oral contraceptive use, age at marriage and clinical presentation were statistically nonsignificant, whereas illiteracy was statistically significant. Most women had poor awareness regarding their need for routine check-up and screening as indicated by the late medical care seeking. Social stigma might have played some role. Relevant programmes should create awareness among women, especially those with socioeconomic deprivation. BSMMU J 2022; 15(3): 175-17