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49 2D ICRU-based vs 3D image-guided planning in high dose rate brachytherapy for cervical cancer – a study on efficacy and treatment-related toxicities
  1. M Faye1,
  2. M Araujo1,
  3. K Alrabiah1,
  4. MD Wissing2 and
  5. J Alfieri1
  1. 1Department of Radiation Oncology, McGill University Health Centre, Canada
  2. 2Division of Cancer Epidemiology, Department of Oncology, McGill University, Canada


Introduction Treatment paradigms for locally-advanced cervical cancer have shifted from the use of 2D-brachytherapy (2D-BT) to that of 3D-image-guided-brachyterapy (3D-IGBT), with the goal of delivering doses more precisely to clinical targets while sparing organs-at-risk. In this retrospective study, we aimed to report our institution’s experience with 3D-IGBT for the treatment of cervical cancer.

Methods Patients with cervical cancer who received chemoradiation between February 2004 and August 2019 were included. Patient data was retrospectively collected until December 2019. 99 patients were treated with 2D-BT and 49 with 3D-IGBT. Treatment-related toxicities (CTCAE v4.0), recurrence-free-survival (RFS) and overall survival (OS) are reported.

Results Median follow-up was 30.4 months (3–170 months). There was no difference in the number of acute toxicities (OR 1.23[0.62–2.46]). There was a significant reduction in combined late toxicities for the 3D-IGBT group (OR 0.24[0.11–0.56]) and specifically for late gastrointestinal toxicities (OR 0.27[0.09–0.86]). Although not significant (NS), acute hematological toxicities were more common in the 3D-IGBT group (OR 2.53[0.94–6.80]) but resolved with time (OR 0.74[0.07–7.90]). The rate of grade≥3 toxicities was very low (2D-BT: 1.5% acute, 2.7% late; 3D-IGBT: 1.0% acute, 0.7% late; NS). RFS (HR 1.41[0.51–3.88], p=0.46), and OS (HR 0.46[0.15–1.39], p=0.63) were not statistically different.

Conclusion Our study showed that 3D-IGBT for the treatment of cervical cancer is associated with a decrease in the rate and grade of late toxicities, specifically late gastrointestinal toxicity. The rate of grade ≥3 toxicity was also low in both groups, making of 3D-IGBT a safe treatment approach for cervical cancer.

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