20P Randomized comparison of four radiotherapy schedules in locally advanced cervical cancer: A prospective study

The study was conducted with the aim to compare four radiotherapy schedules in terms of overall survival (OS), disease-free (DFS), acute & late toxicities locally advanced cervical cancer. A total 73 patients (ECOG 0-1) histologically proven cancer, FIGO stage IIB-IVA were included (December 2020 July 2022). All treated 6 MV Linear Accelerator Volumetric modulated arc therapy (VMAT) whole pelvis. This followed by High dose rate brachytherapy (HDR-BT) intracavitary (ICRT) or interstitial (ISBT) application. Patients randomized into treatment arms: Arm A- EBRT: 45 Gy/ 25 fractions/ 5 weeks; ISBT: Gy / fraction, 4 fractions, twice daily. B- 50 C- ICRT: 7 weekly. D- 3 Positive lymph nodes simultaneous integrated boost (SIB) 55 fractions and concurrent cisplatin at 40mg/m2 all arms. contoured planned on CT based planning system. Response assessment done functional MRI after completion EBRT months completion. median follow-up 19.4 months. mean OS arms A, B, C D 32.3, 15.7, 15.3 34.5 respectively (p= 0.954). DFS 31.9, 11.9, 11.0, 28.8 0.562). Grade 3/4 hematological toxicity seen arm (18.2%), (5.6%) (17.3%). GI present (13%). Radiation proctitis significantly more B (p=0.007). similar outcomes toxicities. However, radiation receiving ISBT.