Until 2011, there were no high dose rate brachytherapy (HDR) services available in Botswana. The objective of our study was to characterize the treatment course and tolerability in women with cervical cancer treated with curative intent (chemo)radiotherapy.
Patients with carcinoma of the cervix receiving radiotherapy between 8/7/13 and 4/24/14 in Botswana were enrolled. Patients were treated with pelvic radiotherapy using a linear accelerator and brachytherapy using a HDR Iridium-192 afterloader +/- weekly cisplatin.
Sixty consecutively treated patients are available for analysis. Median age of the cohort is 50 years. 60% of women had FIGO stage II and 36% had stage III disease. Mean hemoglobin was 11.0 g/dL (range 6.5-14). Median time from diagnosis to treatment was four months (range 0.5-36 months).
60.0% of all patients were (n=35) were HIV+ with median CD4 count 534. 60% presented with stage II and 26% presented with stage III disease.
83% of women were treated with chemoradiation. Median dose of EBRT was 50 Gy. 90% of patients were able to receive brachytherapy (most common fractionation 7 Gy x 3).
Median total treatment time was 49 days (range 24-76). Most common toxicities were radiation dermatitis (75% with grade≥2), diarrhea and nausea (both 42% with grade≥2).
Since 2011, the majority of women receive brachytherapy and chemotherapy as part of their treatment, and complete therapy within 8 weeks. A significant proportion of women with cervical cancer in Botswana are HIV+. Future studies will focus on the outcomes and optimal treatment for this population.