title: A Retrospective Six Years Analysis of Survival and Late Morbidity of Post-operative Gynaecological Malignancy Treated with External Radiotherapy Followed by Brachytherapy in Medical College & Hospitals, Kolkata.
abstract: BACKGROUND
  Cervical and endometrial carcinoma incidentally found in the surgical specimen with high risk pathological finding or with gross residual disease.
  
  
  METHODS
  Between 2004 and 2010, 320 cervical and endometrial cancer patients were treated with EBRT and brachytherapy after having undergone total/subtotal hysterectomy. Sixty patients were lost to follow-up.
  
  
  RESULTS
  Median follow-up was 21 months. Endometrial and cervical cancer with a high risk for local recurrence achieved CR 93.8 and 89 %, respectively. 56 % patients experienced CR with residual disease with cervical cancer. Median OS for endometrial and cervical cancer with residual disease was 8.5 and 24 months, respectively. Grade 3 adverse events were 5 and 3.5 % for rectum and bladder, respectively.
  
  
  CONCLUSIONS
  The incorporation of chemotherapy during pelvic radiotherapy followed by HDR interstitial brachytherapy for residual disease is inadequate and improves survival. We are still in learning phase of brachytherapy in post-operative gynaecological malignancy cases; expertise will be developed by practice.
authors.affiliation: Department of Radiotherapy, Medical College & Hospital, Kolkata, India.
authors.forename: Sourav
authors.initials: S
authors.lastname: Sau
authors.affiliation: Department of Radiotherapy, Medical College & Hospital, Kolkata, India.
authors.forename: Suparna
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Department of Radiotherapy, Medical College & Hospital, Kolkata, India.
authors.forename: Shila
authors.initials: S
authors.lastname: Mitra
authors.affiliation: Department of Radiotherapy, Medical College & Hospital, Kolkata, India.
authors.forename: Amitava
authors.initials: A
authors.lastname: Manna
authors.affiliation: Department of Radiotherapy, Medical College & Hospital, Kolkata, India.
authors.forename: Bidyut
authors.initials: B
authors.lastname: Mondal
authors.affiliation: Department of Radiotherapy, Medical College & Hospital, Kolkata, India.
authors.forename: Koushik
authors.initials: K
authors.lastname: Ghosh
keywords: Brachytherapy; Gynaecological malignancy; Hysterectomy; Survival