Clinical/Radiobiological Study on Viral-Induced Cancers’ Response to Radiotherapy, with Comprehensive Morbidity Assessment

Cervix cancer is one of the more common malignancies in women, particularly in developing countries. A vast majority of the cases are diagnosed in locally advanced stages of the disease, but cure with radiation still is possible.
Radiotherapy plays a dominant role in the treatment of cancer of the uterine cervix. Its curative potential depends greatly on the management of intracavitary brachytherapy (BT), which is administered in combination with external irradiation (EBRT). BT can be either of low dose rate (LDR) or increasingly there is use of high dose rate (HDR). HDR BT is traditionally given in 3 to 6 fractions. Howeverthe use of a 2 fraction regime would double the available physical and human resources. It would also help to shorten the treatment and hence reduce hospital visits for patients.
Since local control still remains a problem in patients with advanced cervical cancer, there have been several trials testing chemotherapy with radiation therapy. There appears to be mixed results with cisplatin and radiation, but cisplatin is increasingly used internationally. Since cisplatin requires increased resources of personnel and money, and can result in increased toxicity, testing the drug with radiation is important.
The association of levels of particular molecular markers with radiotherapy outcome may enable different doses to be delivered to individual patients, producing an overall increase in tumour control without increasing morbidity.
Cancer is a growing public health problem in developing countries. Due to lack of public education and scarcity of adequate health care facilities most patients present with advanced disease. In these patients, radiotherapy plays an indispensable role in both curative and palliative treatments. During radiotherapy, various adverse events occur as a consequence of irradiation of normal tissues.

The ARBR Section plans to add a component on improvement of the capture and assessment of long-term normal tissue effects of radiotherapy, to test the use of specially designed questionnaires that could improve adverse event reporting through the use of electronic capture mode. Questionnaires will be used face to face for patients enrolled and the data obtained that way would be compared with data obtained using the traditional way from patient notes.