Treatment Outcomes of Cobalt-60 Source Based High-Dose-Rate Intra-Cavitary Brachytherapy for Cervical Cancer

Shruti Bansal, Shahid Ali Siddiqui, Zehra Mohsin, Mohsin Khan

Abstract: Background and Objectives: Best survival rate in carcinoma cervix is achieved when EBRT and brachytherapy are used. HDR has largely replaced LDR which was standard system of ICBT. With introduction of after-loading technology, HDR delivery became safe and more precise than LDR brachytherapy. Recently, miniaturized size of Co 60 sources has been made available with identical geometric and dosimetric properties as those of Ir 192. So, Cobalt-60 is a more economical and logistic option for low resource settings like ours. This study aimed to evaluate treatment outcomes carcinoma cervix patients following HDR ICBT with Co-60 source in terms of Acute & late gastrointestinal & genitourinary toxicity, and Local disease control. Methods: Prospective observational study conducted on carcinoma cervix patients who received upfront EBRT with concurrent chemotherapy followed by HDR ICBT using Co-60 source. Acute and late gastro-intestinal and urogenital toxicities were evaluated using RTOG criteria. Treatment response was assessed using RECIST 1.1 criteria. Results: Majority of the patients (75%) had large tumors. 7.7% of patients had ≥ grade 2 upper gastrointestinal toxicities. 25% developed higher grades of acute lower gastrointestinal toxicity. 5.8% developed ≥2 grade of acute genitourinary toxicity. 1 patient developed intestinal obstruction. 93.3% developed only lower grades of late genitourinary toxicity. Complete response was observed in 84.5% of the patients, Partial response in 11%. Conclusion: HDR brachytherapy with newly installed cobalt source yielded acceptable toxicity rates and reassuring response rates. It can be considered as a reliable and cost-effective alternative to existing iridium-192 source.

Keywords: Brachytherapy, cobalt 60, cervix, radiotherapy

How to Cite?: Shruti Bansal, Shahid Ali Siddiqui, Zehra Mohsin, Mohsin Khan, "Treatment Outcomes of Cobalt-60 Source Based High-Dose-Rate Intra-Cavitary Brachytherapy for Cervical Cancer", Volume 14 Issue 8, August 2025, International Journal of Science and Research (IJSR), Pages: 1396-1408, https://www.ijsr.net/getabstract.php?paperid=SR25825234750, DOI: https://dx.doi.org/10.21275/SR25825234750