Aim: To compare and analysis two high-dose-rate intracavitary brachytherapy schedule of 7.5Gy per fraction per for 3 fractions over 6Gy per fraction for 4 fractions in the treatment of carcinoma of uterine cervix.

Materials and Methods: Total 50 patients with carcinoma of the uterine cervix (Stages III) were treated with External Beam Radiotherapy (EBRT) and High Dose Rate Intracavitary Brachytherapy (HDR- ICBT). These were randomized to arm A- 6 Gy per fraction for 4 fractions and arm B – 7.5Gy per fraction for 3 fractions. In both Arms 25 patients were included, out of those 1 patient from Arm Blost during follow up.Then follow up was done after 1yr, 2yr & 3yr to evaluate the Local control rate, disease-free survival and overall survival.

Results: The median follow-up period in the study was 22 months for Arm A and 21 months for Arm B. In the Control Arm A, Local control rate, disease-free survival and overall survival were 84%, 84%and 92 %, respectively, while in the Study Arm B, were 87.50%, 87.50% and  91.66%, respectively (p value >0.05).

Conclusion: In Indian context  taking into account of increased hospital burden of locally advanced cancer cervix patients, HDR intracavitary brachytherapy schedule of 7.5 Gy per fraction 3 fractions is the preferable option over 6 Gy per fraction 4 fractions with regard to comparable, acute and late toxicity, loco-regional control, disease free survival and better patients compliance to lesser fractionation schedule.

Keywords: External beam radiotherapy, Gynecological malignancy, latetoxicity, ICBT _ 6Gy per fraction _ 7.5Gy per fraction.

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Dr Atul Verma

Medical Officer, Radiation Oncology Department, RNT Medical College, Udaipur, India