A PROSPECTIVE RANDOMISED STUDY TO COMPARE IINTERINDIVIDUAL VARIATION IN EFFECT OF RADIOTHERAPY ON URINARY BLADDER AND RECTAL TOXICITY IN PRONE AND SUPINE POSITION IN LOCALLY ADVANCED CANCER OF CERVIX
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Abstract
Introduction: Cancer of the cervix has been the most important cancer among women in the past two decades. In India the peak age for cervical cancer incidence is 55–59 years. In India in every 8 minutes one woman dies of cervical cancer.Radical radiotherapy along with concurrent chemotherapy is the standard of care of advanced carcinoma cervix. Combination of teletherapy and brachytherapy is a conventional practice. Teletherapy includes whole -pelvic radiotherapy which consists of external beam irradiation to the primary tumor and regional lymphatics followed by brachytherapy to boost the gross tumour in the cervix. However, success achieved with this treatment carries a risk of inadvertent normal tissue irradiation of the small bowel, bladder and rectum.
Aims: To study the anticipated reduction in dose in small bowel, urinary bladder irradiated in prone position during pelvic radiotherapy and whether it results in decreased toxicity.
Materials and methods: Prospective randomizedly allocated control study from January 2017 to January 2018 Patients visiting at Radiotherapy department Out door of Nilratan Sirkar Medical College and Hospital,Kolkata-700014.
Result: We found that for the urinary bladder (UB), V20, V30, and V40 showed no significant variance between the two positions (p > 0.05). However, UB V45 demonstrated a notable difference (p = 0.9), while UB V50.4 indicated a statistically significant variance (p = 0.021), indicating higher radiation exposure in the supine position. UB Dmean and total volume did not exhibit substantial differences (p > 0.05) and Regarding the rectum, V20, V30, V40, and V45 showed no significant variation between positions (p > 0.05). However, rectum V50.4 indicated a significant difference (p = 0.004), implying higher radiation exposure in the prone position. Rectum Dmean and total volume did not display substantial differences (p > 0.05).
Conclusion: In conclusion, our study revealed varied radiation exposure in prone versus supine positions. The urinary bladder indicated higher exposure in supine (V50.4 p = 0.021), while the rectum exhibited increased exposure in prone (V50.4 p = 0.004). Overall, patient positioning significantly influences organ-specific radiation doses
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References
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