Background: Worldwide, Cervical carcinoma is the fourth most common cancer in women and seventh most Common overall (GLOBOCAN 2018). Carcinoma cervix accounts for about 569,847 patients around the world out of which 311,365 accounts for death worldwide. Total 14,389 patients were registered in Dr. BRAM Hospital (2012-2015). Out of these 2738 patients were carcinoma cervix. Carcinoma cervix consists of 18% of total cancer registered. Brachytherapy has got a pivotal role in the treatment of carcinoma cervix. Modern day image based brachytherapy has further improvised the treatment results. To allow for maximal tumor radiation dose while limiting exposure to the immediate adjacent organs at risk (OARs) during ICRT in carcinoma cervix, the method available is to manually displace these OARs so that they are located at some distance from the tumor. This is conventionally accomplished by using vaginal gauge packs around central tandem to allow required space between source and rectum. Objective: Evaluation the doses to rectum while using a specially designed Rectum Bladder Spacer Balloon in high dose rate brachytherapy in patients of carcinoma cervix. Method: This prospective clinical study involved 50 histopathological proven patients, conducted during October 2017 to December 2018 in the department of Radiotherapy, Pt. JNM medical college and Regional cancer centre (RCC) of Dr. BRAM Hospital Raipur. Informed written consent, detail history and complete Physical examination were performed in every patient. The vaginal applicators were applied aseptically with spacer balloon and proper simulation with CT, treatment was executed i.e. 7 Gy in 3 # with usage of balloon applicator every time. Patients were assessed every month for toxicities till one year post treatment. USG and physical examination was done post treatment for assessing clinical response. Frequency tables were used to describe impact of treatment on different stages using chi –square test. Result: In this study the majority of patients (34%) had per vaginal bleeding and per vaginal white discharge as symptoms, 92% of patients had histology squamous cell carcinoma rest were had different histopathology In this study maximum number of patients 46% belonged to 50-60 years age group followed by 22% in 30-40 year group. 37 out of 50 (82%) patients were of low socioeconomic status. 50% patients in this study belonged to stage IIB, and 34% were having stage IIIB disease.80% patients showed Complete response and 12.5% showed partial response to disease treatment on 6 monthly follow up. Dose to rectum on 3rd ICRT was found 400.3cGy on 5 cc volume and 706.8cGy on .1cc volume Conclusion: We observed in our study that The dose (in cGy) at 5cc of rectum in terms of mean of 40 patient at 1st ICRT, 2nd ICRT and 3rd ICRT were as 706.1±59.9, 705±53.6 and 706.8±60.1 respectively with a mean of 400.23±39.93.The Mean dose ±SD (in cGy) at first ICRT , second ICRT, and third ICRT of all 40 patients (in total number of 120 ICRT) at 0.1 cc ,0.2cc, 2cc and 5cc of rectum is 706.33±57.86 ,606.13±64.06 ,494.7±45.2 ,400.23±39.93 respectively.
