Objective: The purposes of this trial were to demonstrate the feasibility and effectiveness of the hybrid of intracavitary and interstitial brachytherapy (HBT) for locally advanced cervical cancer patients in the phase I/II prospective clinical trial. Methods: Patients with FIGO stage IB2-IVA uterine cervical cancer pretreatment width of which was ≥5 cm measured by magnetic resonance imaging were eligible for this clinical trial. The protocol therapy included 30–30.6 Gy in 15–17 fractions of whole pelvic radiotherapy concurrent with weekly CDDP, followed by 24 Gy in 4 fractions of HBT and pelvic radiotherapy with a central shield up to 50–50.4 Gy in 25–28 fractions. The primary endpoint of phase II part was 2-year pelvic progression-free survival (PPFS) rate higher than historical control of 64%. Results: Between October 2015 and October 2019, 73 patients were enrolled in the initial registration and 52 patients proceeded to the secondary registration. With the median follow-up period of 37.3 months (range, 13.9–52.9 months), the 2- PPFS was 80.7% (90% confidence interval [CI]=69.7%–88%). Because the lower range of 90% CI of 2-year PPFS was 69.7%, which was higher than the historical control ICBT data of 64%, therefore, the primary endpoint of this study was met. Conclusion The effectiveness of HBT were demonstrated by a prospective clinical study. Because the dose goal determined in the protocol was lower than 85 Gy, there is room in improvement for local control. A higher dose might have been needed for tumors with poor responses.

Schistosomiasis japonica is one of seven NTDs endemic in the Philippines that continues to threaten public health in the country. The causative agent, the blood fluke Schistosoma japonicum, uses an amphibious snail Oncomelania hupensis quadrasi which can harbor larval stages that multiply asexually, eventually producing the infective cercariae which are shed into the water. Contamination of freshwater bodies inhabited by the snail intermediate host occurs through release of human and animal feces containing S. japonicum eggs. Miracidia hatching from these eggs subsequently infect the snails that inhabit these water bodies. The degree of fecal contamination can vary across snail sites and influences snail infection rates in these sites. In this study, conventional malacological surveys using intensive manual search for snails were conducted from 2015 to 2016 in seven selected endemic provinces, namely Leyte and Bohol in the Visayas and Surigao del Norte, Agusan del Sur, Bukidnon, Lanao del Norte and Compostela Valley in Mindanao. A total of 6,279 O. hupensis quadrasi snails were collected from 38 snail sites. The municipality of Trento in Agusan del Sur recorded the highest number of snail sites (7) that yielded O. hupensis quadrasi snails while only one snail site was found positive for O. hupensis quadrasi snails in Kapatagan in Lanao del Norte and Talibon in Bohol. Alegria in Surigao del Norte yielded the highest number of snail sites (5) that were found to harbor snails positive for S. japonicum infection. The snail infection rates in this municipality ranged from 0.43% to 14.71%. None of the snails collected from Talibon in Bohol was infected. Bohol is the only province among the 28 schistosomiasis-endemic provinces which has reached near elimination status. Snail infection rates were found to vary considerably across snail sites, which could be due to the degree of fecal contamination of the snail sites and their connectivity to water that can serve as contamination source.