Outcomes in patients of carcinoma cervix Stage IIIB treated with definitive radiotherapy.

BACKGROUND: Cervical cancer is the fourth most common cancer in women. Although cervical cancer screening is available in India, there is lack of awareness and access to screening services. Consequently, most cancers are diagnosed in advanced stagesoften with obstructive uropathy. PATIENTS AND METHODS: This was a retrospective study of stage III B (as per pre-2018 FIGO staging) cervical cancer patients who received radiotherapy at our center between 2012 and 2019. Patients with or without obstructive uropathy, age group between 18 and 85 years, were included. Definitiveradiotherapy (RT) was delivered with 3D CRT to a dose of 50 Gy in 25 fractions over 5weeks given to whole pelvis and boost of 54 Gy was given to para-aortic or retroperitoneal lymph nodes when enlarged. All patients received intracavitary brachytherapy. RESULTS: 3-year overall survival rates for patients who received only RT was 24% versus 71% for those who received chemoradiotherapy (p = 0.0001). 5-year survival for patients who received RT alone was 12% versus 63% for those who received chemoradiotherapy (p = 0.0001). 3-year PFS was 77% versus 83% and those with and without obstructive uropathy respectively. (p = 0.0001). Overall, 37(56%) patients were alive without any evidence of recurrence. CONCLUSION: Early recognition and appropriate intervention for obstructive uropathy can potentially limit the detriment to outcomes in these patients and result is good long-term cure rates in these patients.

Return to work in survivors of Primary Brain Tumours treated with Intensity Modulated Radiotherapy.

MINI: Primary Brain Tumour survivors usually have significant morbidity, especially cognitive and neurological dysfunction. Return to pre-diagnosis work can be an important QoL indicator and outcomes measure in these patients. We did a retrospective study to assess return to work amongst the patients who underwent radiotherapy at our centre. BACKGROUND: Primary brain tumour (PBT) survivors have a high burden of morbidity. Return to work (RTW) is an important survivorship parameter and outcomes measure in these patients, especially in developing countries. This study was done to assess RTW after radiotherapy, reasons for no RTW, and relationship of RTW with treatment and patient factors. PATIENTS AND METHODS: A single centre study was done amongst PBT patients. Baseline and treatment details, education, employment was assessed. RTW assessed as: time to RTW, full/ part-time, reasons for no RTW and RTW at 6 months post-therapy, and last follow up. RESULTS: 67 PBT patients with a median age of 42 years were assessed. Most common diagnosis was low grade glioma. Over 66% patients were illiterate, and 62% had semi-skilled and unskilled jobs, mostly agriculture. About 64.4% patients returned to employment in a median time of 3 months. At 6 months post-treatment 58.2% had a job, with only 42% working full-time. 'Limb weakness' (21.4%), followed by 'loss of job/ no job' (16.7%), 'fatigue'/ 'tiredness' (14.3%), 'poor vision/ diminished vision' (11.9%) were the common reasons for no RTW. The factors found to be significantly associated with return to work were younger age (p = 0.042), male sex (0.013), the absence of complications during radiotherapy (p = 0.049), part time job prior to diagnosis (p = 0.047), and early return to work after RT (p < 0.001). CONCLUSION: Studies are needed to identify the barriers in re- employment and steps to overcome them in cancer patients.