Title: Retrospective Comparative Study of Clinical Outcome of X ray Based Versus Computed Tomography Based Treatment Planning in Conventional Radiotherapy in Carcinoma Cervix

Authors: Minakshi Roy, Vinita Trivedi, Rita Rani, Richa Chauhan, Usha Singh

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.232

Abstract

Introduction: In conventional radiotherapy of carcinoma cervix treatment planning can be done by X ray simulation or CT simulation.

Objectives: To analyze whether CT simulation can provide better treatment outcome in carcinoma cervix.

Methods: 182 patients of carcinoma cervix treated in our institute in the time period 2010-2011 and matched the inclusion criteria of study (age between 50 to 65 years, stage IIA to IIIB, has taken minimum 3 cycle of concurrent chemotherapy) was analysed for their clinical outcome in terms of treatment failure, distant metastasis, loco regional recurrence, residual disease.

Results: CT based planning showed better treatment outcome in terms of less distance mets, residual disease, loco regional recurrence and improved disease-free survival and overall survival.

Conclusion: CT based radiotherapy planning has improved clinical outcome in case of carcinoma cervix. So CT based radiotherapy planning is a good option for carcinoma cervix patient who do not afford 3D CRT.

References

  1. S C. "Conventional four field radiotherapy versus computed tomography-based treatment planning in cancer cervix: A dosimetric study.” South Asian journal of cancer 2013;2:132. [PubMed]
  2. Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P et al. Randomised study of radical surgery versus radioth-erapy for stage Ib-IIa cervical cancer. Lancet. 1997;350:535-40 [PubMed]
  3. Horiot JC, Pigneux J, Pourquier H, Schraub S, Achille E, Keiling R et al. Radiotherapy alone in carcinoma of the intact uterine cervix according to G. H. Fletcher guidelines: A French cooperative study of 2383 cases. Int J Radiat Oncol Biol Phys 1988;14:605–611. [PubMed]
  4. Perez CA, Grigsby PW, Nene SM, Camel H M, Galakatos A, Kao M S et al. Effect of tumor size on the prognosis of carcinoma of the uterine cervix treated with irradiation alone. Cancer 1992;69:2796-2806 [Google Scholar]
  5. Goswami J, Patra NB, Sarkar B, Basu A, Pal S. Dosimetric comparison between conventional and conformal radiotherapy for carcinoma cervix: Are we treating the right volumes? South Asian J Cancer. 2013;2:128-31. [PubMed]
  6. Saibishkumar EP, Patel FD, Sharma SC. Results of radiotherapy alone in the treatment of carcinoma of uterine cervix: A retrospective analysis of 1069 patients. Int J Gynaecol Cancer. 2005;15:890–7. [PubMed]
  7. Saibishkumar EP, Patel FD, Sharma SC. Evaluation of late toxicities of patients with carcinoma of cervix treated with radical radiotherapy: An audit from India. Clin Oncol. 2006;18:30–7. [PubMed]
  8. Lanciano RM, Pajak TF, Martz K, Hanks GE. The influence of treatment time on outcome for squamous cell cancer of the uterine cervix treated with radiation: A patterns-of-care study. Int J Radiat Oncol Biol Phys. 1993;25:391–7. [PubMed]
  9. Greer BE, Koh WJ, Figge DC, Russell AH, Cain JM, Tamimi HK. Gynaecologic radiotherapy fields defined by intra-operative measurements. Gynecol Oncol. 1990;38:421–4. [PubMed]
  10. Russell AH, Walter J, Anderson MW, Zukowski CL. Sagittal magnetic resonance imaging in the design of lateral radiation treatment portals for patients with locally advanced squamous cancer of the cervix. Int J Radiat Oncol Biol Phys 1992;23:449–455. [PubMed]
  11. Zunino S, Rosato O, Lucino S, Jauregui E, Rossi L, Venencia D. Anatomic study of the pelvis in carcinoma of uterine cervix as related to the box technique. Int J Radiat Oncol Biol Phys. 1999;44:53–9. [PubMed]
  12. Mc Alpine A, Schlaereth JB, Lim P, Chen D, Eisenkop SM, Spiritos NM. Radiation fields in gynecologic oncology: Correlation of soft tissue (surgical) to radiologic landmarks. Gynecol Oncol. 2004; 92:25–30.[PubMed]
  13. Khamanarong K, Sae-Jung S, Supa-Adirek C, Teerakul S, Prachaney P. Aortic bifurcation: a cadaveric study of its relationship to the spine.  J Med Assoc Thai 2009 Jan;92:47-9. [PubMed]
  14. Chithriki M, Jaibaji M, Steele RD. The anatomical relationship of the aortic bifurcation to the lumbar vertebrae: a MRI study.  Surg RadiolAnat2002;24:308-12. [PubMed]

Corresponding Author

Minakshi Roy