Comparing doses and fractionation regimens for high dose rate brachytherapy in locally advanced cervical carcinoma: A randomized controlled trial

Abstract

Background: Cervical cancer is among the most common gynecologic malignancies encountered in Low and Middle Income Countries. Tanzania, and the whole East African region where it belongs, has cervical cancer as the first malignancy in women, in both incidence and mortality. Despite the advances in management of cervical carcinoma, most of the Low‐Income Countries lag in terms of treatment planning and delivery, considering the loads of patients that consult on a regular basis. Locally advanced cervical cancer status, as defined by the International Federation of Gynecology and Obstetrics confers to the patient a high recurrence and low survival rate risks altogether. Survival rates have been shown to have a decreasing tendency as the cancer stage increase. According to FIGO classification, the management of a locally advanced cervical cancer consists of a course of combined radiotherapy and chemotherapy, with a few added weeks of brachytherapy. As it has been shown before, both exposure and toxicity to any of the available treatment options could be lowered if some factors are taken into consideration. Encouraging results have been shown elsewhere. This study compares two different dose fractionations of High dose rate brachytherapy for selected cases of cervical carcinoma, and seeks to prove feasibility of both.