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Dose at posterior-inferior border of symphysis point: A predictor for vaginal stricture in cervical cancer

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dc.contributor.authorSingh, Ankita
dc.contributor.authorMani, Nilesh
dc.contributor.authorAggarwal, Lalit M.
dc.contributor.authorAgarwal, Sumit
dc.contributor.authorMourya, Ankur
dc.contributor.authorVerma, Ashish
dc.contributor.authorBagchi, Antara
dc.contributor.authorGupta, Neha
dc.contributor.authorChoudhary, Sunil
dc.date.accessioned2025-01-28T09:38:59Z
dc.date.available2025-01-28T09:38:59Z
dc.date.issued2023
dc.description.abstractPURPOSE: To study the effect of various dose-volume parameters on the severity of vaginal stricture (VS) and the correlation of the latter with the posterior-inferior border of symphysis (PIBS) points in locally advanced cervical cancer patients treated with concurrent chemoradiation and brachytherapy. METHODS AND MATERIALS: A prospective study was done on 45 histologically proven locally advanced cervical cancer patients between January 2020 and March 2021. All of them were treated with concurrent chemoradiation with 6 MV photon linear accelerator to a dose of 45 Gy/25 fractions in 5 weeks. Twenty-three patients were treated with intracavitary brachytherapy with a dose of 7 Gy/fraction/week for three fractions. Twenty-two patients were treated with interstitial brachytherapy, with 6 Gy/fraction for four fractions, each fraction 6 h apart. Grading of VS was done as per Common Terminology Criteria for Adverse Events version 5. RESULTS: The median followup was 21.5 months. About 37.8% of patients had VS with a median duration of 8.0 months (4.0�12 months). About 22.2% had Grade 1, 6.7% had Grade 2, and 8.9% had Grade 3 toxicity. Doses at PIBS and PIBS?2 points had no correlation with vaginal toxicity, however, the dose at PIBS+2 was significantly associated with VS (p = 0.004). The treated length of the vagina at the time of brachytherapy (p = 0.001), initial tumor volume (p = 0.009), and vaginal involvement after completion of external beam radiotherapy (EBRT) (p = 0.01) were also statistically significant with the development of VS of Grade 2 or more. CONCLUSIONS: Dose at PIBS + 2, treated length of the vagina with brachytherapy, initial tumor volume, and post-EBRT vaginal involvement are strong predictors for the severity of VS. � 2023 American Brachytherapy Society
dc.identifier.doihttps://doi.org/10.1016/j.brachy.2023.04.010
dc.identifier.issn15384721
dc.identifier.urihttps://dl.bhu.ac.in/ir/handle/123456789/21893
dc.language.isoen
dc.publisherElsevier Inc.
dc.subjectBrachytherapy
dc.subjectCarcinoma cervix
dc.subjectStrictures
dc.subjectVaginal dose
dc.subjectVaginal stenosis
dc.titleDose at posterior-inferior border of symphysis point: A predictor for vaginal stricture in cervical cancer
dc.typeArticle
dspace.entity.typePublication
journal.titleBrachytherapy
journalvolume.identifier.volume22

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