Role of radiation therapy in the management of cancer of the uterine cervix
Verified by Dr. Sandeep De – Senior Consultant Radiation Oncology & Dr. Dipalee Borade – Consultant Radiation Oncology at Apollo Cancer Centres in Navi Mumbai.
As per the WHO Body report, Cancer of the Uterine Cervix is one of the three most common cancers in India & the 2nd most common cancer in women (Breast cancer being 1st), accounting for 1.2 lakh cases in 2022.
The cervix is the lower, narrow end of the uterus (womb). The cervix connects the uterus to the vagina (birth canal). Cervical cancer is a serious health concern for women. Radiation therapy plays a crucial role in the treatment of uterine cervix cancer. It’s often used either alone or in combination with surgery and/or chemotherapy, depending on the stage and characteristics of the cancer. Radiation therapy targets cancer cells with high-energy rays, damaging their DNA to prevent further growth and division. For cervical cancer, there are two main types of radiation therapy: External beam radiation therapy (EBRT) and Brachytherapy.
External Beam Radiation Therapy (EBRT) and Brachytherapy are both integral components in the comprehensive management of cervical cancer, offering complementary benefits and improving treatment outcomes. Here’s their combined role:
EBRT:
• Primary Treatment: EBRT is often used as the primary treatment for cervical cancer, particularly in cases where surgery is not feasible or preferred by the patient. It delivers high-energy X-rays to the pelvic region, targeting the tumor and nearby lymph nodes.
• Adjuvant Therapy: Following surgery, EBRT may be administered as adjuvant therapy to eradicate any remaining cancer cells and reduce the risk of recurrence. It helps improve local control and reduces the likelihood of disease progression.
• Neoadjuvant Therapy: EBRT can be used before surgery (neoadjuvant therapy) to shrink the tumor, making it more amenable to surgical resection. This approach may increase the success rate of surgery and improve long-term outcomes.
• Palliative Therapy: In advanced or metastatic cervical cancer, EBRT can be employed as palliative therapy to alleviate symptoms and improve quality of life by reducing tumor size and relieving associated symptoms.
Brachytherapy:
• Localized Treatment: Brachytherapy involves the placement of radioactive sources directly into or near the tumor, delivering a high dose of radiation precisely to the cancerous tissues while sparing surrounding healthy organs.
• Boost to EBRT: Brachytherapy is often used as a boost following EBRT, further intensifying the radiation dose to the tumor site. This approach enhances treatment efficacy and improves local control of the disease.
- High Dose Rate (HDR) vs. Low Dose Rate (LDR): Brachytherapy can be administered in two main forms: HDR and LDR. HDR brachytherapy delivers a high dose of radiation over a short period, typically in multiple sessions over a few days, while LDR brachytherapy delivers a continuous low dose of radiation over a longer period, often requiring a hospital stay. Both approaches are effective, with HDR brachytherapy being more commonly used due to its convenience and shorter treatment duration
• Improves Disease Control: By delivering high doses of radiation directly to the tumor, brachytherapy significantly improves local disease control and reduces the risk of recurrence.
• Preservation of Organs: Brachytherapy minimizes radiation exposure to adjacent healthy tissues, preserving organ function and reducing the likelihood of radiation-related complications.
- Overall Survival Benefit: Studies have demonstrated that the addition of brachytherapy to EBRT significantly improves overall survival rates and disease-free survival in patients with cervical carcinoma, making it an essential component of treatment.
Combined Modality Treatment:
• Chemoradiation: EBRT and brachytherapy are frequently combined with chemotherapy in a multimodal approach known as chemoradiation therapy. This comprehensive treatment strategy has been shown to significantly improve survival rates and disease control compared to radiation therapy or chemotherapy alone.
In summary, by combining EBRT and brachytherapy, clinicians can effectively target the tumor from both external and internal sources, delivering potent radiation therapy while minimizing damage to surrounding healthy tissues. This comprehensive approach improves treatment outcomes, enhances local disease control, and contributes to better overall survival rates for patients with cervical cancer.
Potential Side Effects
As with any medical treatment, radiation therapy can cause side effects. These may include:
- Fatigue
- Skin irritation in the treated area
- Diarrhea
- Increased Frequency or burning while passing urine
- Sexual dysfunction
These side effects are usually temporary and manageable with medication and supportive care.
Radiation therapy is a powerful against cervical cancer. By understanding its uses, benefits, and potential side effects, patients can make informed decisions about their treatment plan. If you have any concerns about radiation therapy for cervical cancer, discussing them with your doctor is crucial. They can address your specific situation and provide personalized guidance throughout your treatment journey.
Consult our experts, Dr. Sandeep De – Senior Consultant Radiation Oncology & Dr. Dipalee Borade – Consultant Radiation Oncology at Apollo Cancer Centres in Navi Mumbai for more details.
Call 022 6280 6280 for an appointment.