Retrospective Evaluation of the Bifractionated Scheme in Utero-Vaginal Brachytherapy in the Treatment of Cervical Cancer : Experience of the Radiotherapy Oncology Service at Marrakech University Hospital

Abstract

Objective: To retrospectively report the results in terms of local control and toxicities, of the 2 x 9 Gy fractionation used in our service, in high dose rate brachytherapy, during the treatment of locally advanced cervical cancer, preceded by a concomitant chemotherapy radiotherapy association. Material and method: Report and analyze data from 106 patients treated in our center between 2015 and 2018, for cervical cancer stage IIB and IIIB according to the FIGO classification. Results: The median follow-up was 29 months. Among the 106 patients analyzed, 75.5% had good local control at 3 years against 7.5% who had local progression, while 9.5% had local relapse and 7.5% had metastatic relapse. The average time for the occurrence of an event (progression, local or remote relapse) was 8 months. Most patients (90.6%) did not have acute toxicity. As for chronic toxicities, 66% had good long-term tolerance, while 27.4% had synechiae or even vaginal stenosis. The other toxicities were in the minority. Conclusion: Despite the considerable advantage of 2 x 9 Gy fractionation in uterovaginal brachytherapy in terms of reduction in treatment time, it is not the ideal choice in terms of local control and toxicity and the 3 x 8 Gy scheme seems a good alternative.