18P Prospective randomized comparison of quality of life in locally advanced cervical cancer treated with intracavitary or interstitial brachytherapy

The quality of life (QoL) of patients with cervical cancer is of paramount concern in addition to their survival outcomes. The rationale of this study was to assess the QoL of the patients of locally advanced cervical cancer treated with chemoradiation and to estimate its difference when treated with two different brachytherapy (BT) techniques: Intracavitary (ICRT) or Interstitial brachytherapy (ISBT). Forty-five, previously untreated, carcinoma cervix patients of FIGO stage IIB to IVA who were registered at the Institute of medical sciences, Banaras Hindu University, from December 2019 to March 2021 were included in the study. The patients were randomized into two BT arms, ICRT & ISBT, using simple randomization. The QoL was studied using structured European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires C30 (QLQ-C30), and Cervical Cancer Module (Cx24). The baseline observations were recorded on the day of registration and then after three months of completion of treatment. These patients were treated with 6 MV photon with VMAT to a dose of 45Gy-55Gy in 25 fractions followed by ICRT (7Gy/#,3 #, 1#/week) or ISBT (6 Gy/#, 4#, 6 hours apart over 2 consecutive days). BT planning was done on Oncentra treatment planning system. At 3 months of treatment completion, mean scores of global health status were 84.93 and 77.8 in the ICR and ISBT arm (p=0.019). The mean scores for physical functioning, emotional functioning, and social functioning were 92.81 and 94.3 (p=0.039), 96.75 and 87.16 (p= 0.000), 56.76 and 53.34 (p=0.002) for ICR and ISBT arms respectively. The difference in mean scores of fatigue, menopausal symptoms, the sexual worry was significant. The increment in peripheral neuropathy scores was more in the ISBT arm as compared to the ICRT arm (p=0.05) post-treatment completion. There was also a significant increase in sexual activity and an improvement in sexual enjoyment scores for the patients treated with ISBT (p=0.02). QoL was improved in both treatment arms. However, the improvement was significantly more in the patients treated with intracavitary brachytherapy as compared to those treated with interstitial brachytherapy.