A PROSPECTIVE STUDY ON DAILY LOW DOSE CISPLATIN CONCURRENT WITH INTENSITY MODULATED RADIOTHERAPY IN LOCALLY ADVANCED CARCINOMA CERVIX

Abstract

Treatment of locally advanced cervical cancer evolved from EBRT alone to EBRT plus ICRT to EBRT with concurrent chemotherapy plus ICRT. Concurrent cisplatin therapy is usually administered on a weekly or three weekly basis. The doses of Cisplatin used in the weekly or three weekly regimen may not be tolerated well by all patients, resulting to fewer patients being able to receive the total planned effective dose of concurrent chemotherapy. Experimental data suggest that antitumor activity of cisplatin may be greater if administered by continuous infusion. Preliminary studies have also shown that low dose, daily Cisplatin with radiotherapy may be better tolerated along with similar response rates, especially in older age patients. Results: Overall 96.8 % (30 out of 31) of the patients had complete response and 3.2% (1 out of 31) patients had partial response. Almost all (except one) the patients in the study received a cumulative dose of 200 mg/m2 of concurrent Cisplatin. Acute grade 3 toxicities were observed mostly in the form of diarrhoea and skin toxicity. Grade 3 diarrhoea occurred in 14 patients (45.2%). Incidence of acute grade 3 skin reaction was seen in 2 patients (6.5%), whereas the incidence of acute grade 3 haematological toxicity , genitourinary toxicity and grade 3 nausea and vomiting was nil. Conclusions: Adaily low dose cisplatin prior to radiotherapy might lead to an increased radiosensitization as well as better tolerance than other regimens.