Background: Patients with locally advanced cervical cancer are often
severely distressed with incessant vaginal bleeding, offensive
discharge and pelvic pain and are in some instances are beyond curative
potential. At our institution we routinely use monthly palliative
pelvic radiotherapy for these patients. Methods and Material: One
hundred patients treated between 2000 & 2004 were included in this
analysis. Patients were treated with parallel-opposed pelvic portals
with megavoltage radiation monthly up to a maximum of three fractions
(10Gy/ fraction). Patients with good response after second fraction
were considered for intracavitary brachytherapy delivering 30Gy to
point A. Response was documented with regard to relief of bleeding,
vaginal discharge and pelvic pain. The other aspects evaluated were
patient compliance, disease response, toxicity and survival. Results:
Sixty-eight percent had FIGO stage IIIB, 12% had stage IVA and 14% had
IVB disease. Twenty patients had metastatic disease. The median symptom
duration was 5 months. Majority (67%) presented with vaginal bleeding,
followed by discharge (69%) and pelvic pain (48%). All patients
received at least one fraction of palliative pelvic radiotherapy.
Sixty-one patients received the second fraction and 33 the third. Five
patients received an intracavitary application. The overall response
rates in terms of control of bleeding, discharge and pain were 100%,
49% and 33% respectively. The treatment was generally well tolerated
with a median survival of 7 months. Conclusions: Monthly palliative
pelvic radiotherapy results in satisfactory control of symptoms in
patients with locally advanced carcinoma of cervix with acceptable
complications
