Background:Traditionally brachytherapy planning was based on dose prescription to specific points for the tumor and for OARs. Incorporation of CT and MRI allow sectional image based approach with better assessment of GTV, accurate delineation of CTV and Organs at risk (OARs) compared to traditional approaches. Moreover, with 3D volume and image based planning, treatment of complex shaped cervical cancers has achieved excellent results.
Aim: Our aim was to see the feasibility of IBBT in carcinoma cervix in developing countries where resources are low but carcinoma cervix is the commonest female malignancy.
Methods:A retrospective analysis of 53 patients of carcinoma cervix between April 2012 and November 2013 was done. 50 Gy of EBRT with weekly cisplatin, and4 sessions of Image based ICBT of 7 Gy each was the treatment protocol. For 7 patients MRI was done at each brachytherapy session, while for the rest of the 46 patients MRI was done at the first session of brachytherapy only and CT scan for the others .Dose was prescribed to HRCTV and constraints were given to rectum & bladder.
Results: For all patients 3D volume based plans were done. The mean dose to HRCTV was 6.74 Gy. The mean rectum and bladder doses were 4.61 and 4.26 Gy respectively. 47 patients (88%) showed more than 80% response after external beam radiotherapy. No patients had grade 3,4 toxicities.
Conclusions:In Asian countries too IBBT can be adopted, though availability of CT/MRI facilities and soft wares, compatible applicators and adequate training may be initial limitations.