High Dose Rate Brachytherapy in the Treatment of cervical cancer: preliminary experience with cobalt 60 Radionuclide source—A Prospective Study

UNLABELLED Iridium-192 is widely used for high-dose rate brachytherapy. Co-60 source with similar geometric and dosimetric properties are now available. It has a longer half life but higher energy than Iridium-192. If Co-60 source can produce similar results, it will be more economical for low resource settings. OBJECTIVE To evaluate the acute gastrointestinal and genitourinary toxicity associated with Co-60 source in the brachytherapy of cervical cancer. METHODS Seventy patients with cervical cancer received 45 Gy in 22 fractions of pelvic external beam radiotherapy and 19.5 Gy in 3 fractions of HDR with Co-60 source using tandem and ring applicators with 6 courses of cisplatin 50 mg/m(2) and 5 fluorouracil 1000 mg/m(2) every 3 weeks Toxicity was scored using NCI-CTC version 4.0. RESULTS The median total BED (Gy(10)) for tumor was 86.2 (84.4-88.8) while that for rectum (BED Gy(3)) was 124.4 (120-133). Two patients (3%) had grade 3 gastrointestinal toxicity while all others had ≤grade 2 toxicity and this is comparable with previous results. CONCLUSION Co-60 as HDR brachytherapy source is tolerable and is economical for low resource settings.