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A significant portion of Carcinoma Cervix cases present in advanced stage. For these palliative radiotherapy is a viable alternative. Aim of palliation is mostly to provide symptomatic relief. In a small subset of patients’ good response warrants further attempt at treatment with curative intent.

Retrospective analysis of 36 patients who received 30Gy/10# followed by EBRT (External Beam Radiotherapy)/Brachy boost from January 2012 to December 2016 was done. These patients had a relatively early age of presentation had preserved physical function and had good performance status. They received 30Gy/10# over 2weeks EBRT (Phase1) by conventional technique following which they were either given a EBRT boost of 20Gy/10# or Brachytherapy 7.5GyX2# (Phase 2). At the end of Phase 1 a subjective as well as an objective analysis was done. A CECT was done 3 months following completion of Phase 2.

The median age presentation of the cohort is 46 years (IQR 39-56). Most common presenting symptom was vaginal bleeding in 29 (80.5%) patients followed by pelvic pain 19(52.7%). Following phase 1; greater than 50% objective response (as measured on CECT) was observed in 26 (72.2%) patients, remaining patients had static disease. At completion of treatment (Phase 2) 19 (52.7%) patients had complete radiological response whilst remainder had biopsy proven residual disease. We present an analysis of these 19 patients. The median DFS was 3.2 years. Most common site of failure was paraaortic nodes 7 (36.8%) followed by local relapse 4 (21%), one patient presented with lung metastasis, 4 patients have lost to follow up and 3 (15%) patients stay symptomatic as of now. On univariate analysis size of tumour greater than 6 cm was found to be significant (p=0.04). On multivariate analysis size of tumour and duration of symptoms were found to be significant.

A small subject of carefully selected patients despite their advanced disease shows good response to palliative hypo-fractionated radiotherapy. In these further radiation by means of external beam radiotherapy or brachytherapy can be contemplated with satisfactory results.