Abstract Background: Given the risk of disease recurrence in para-aortic lymph nodes, prophylactic extended-field radiotherapy (EFRT) is advocated for locally advanced carcinoma of the cervix. However, irradiation of such a large volume by conventional techniques can cause severe normal tissue toxicity. Therefore, intensity modulated radiation therapy (IMRT) has emerged to achieve a similar treatment response with an acceptable level of toxicity. In this study, we evaluated the acute toxicity profile and treatment response to EFRT by IMRT in patients with locally advanced cervical carcinoma. Materials and Methods: It was a prospective single-arm study involving 58 patients with locally advanced cervical carcinoma, who were treated with prophylactic EFRT by IMRT at a dose of 50 Gy/25 fractions/5 weeks, with concurrent cisplatin (40 mg/m 2 ), followed by intra-cavitary brachytherapy between March 2021 and August 2022. Treatment-related acute toxicities were monitored, and response assessment was done at 6 weeks, 3 months, and 6 months after treatment. Results: Grade 3 anemia and neutropenia were found in 29.3% and 6.9% of cases, respectively. Around 9% of patients had Grade 3 gastrointestinal toxicity, and 8.6% of patients had Grade 2 genitourinary toxicity. Six months after treatment, 97% of patients showed an overall response (complete or partial). Only one patient showed evidence of progression. At a median follow-up of 15 months, 9 (15%) patients had treatment failure due to disease recurrence or metastasis. Mean recurrence-free survival was 13.8 ± 0.380 months. Conclusion: Prophylactic extended-field IMRT in locally advanced cervical carcinoma is beneficial in reducing treatment failure rates with acceptable toxicity.
Ray et al. (Thu,) studied this question.