Comparing Weekly versus Three Weekly Schedules of Cisplatinum Concomitant with Radical Radiotherapy in Locally Advanced Carcinoma Uterine Cervix

Abstract

Aims and 0bjectives: To determine and evaluate the difference/s, in terms of tumor control and side effects, between weekly and three weekly cisplatin concomitant with radical course of radiotherapy for locally advanced carcinoma of cervix. Materials and methods: The study was conducted on sixty previously untreated, histopathologically proven patients of locally advanced carcinoma of uterine cervix. The patients were treated with External Beam Radiotherapy (EBRT) 50Gy in 25 fractions over 5 weeks and concomitant cisplatin, followed by intra-cavity HDR brachytherapy (ICBT) 700cGy to point A, once in a week for three weeks. The patients were assigned randomly either of two groups of 30 patients each. In Group I (Study Group) the patients received three weekly cisplatin 75 mg/m2 for 2 cycles while in Group II (Control Group) the patients received weekly cisplatin 40 mg/m2 for 5 cycles. Evaluation of response and toxicity was done weekly during treatment and monthly thereafter. The data thus obtained was assessed and analysed using SPSS version 20.0 statistical tool. Results: There was statistically insignificant higher incidence of hematological , skin , mucosal toxicity and GI toxicity in group I. Stage wise disease status at the end of sixth month follow up was as follows: Stage IIA-NED* (80% vs. 100%), RD** (20% vs. 0%);Stage IIB - NED (80% vs. 76.67%), RD (20% vs. 23.53%); Stage IIIA - NED (60% vs. 100%), RD (40% vs. 0%); Stage IIIB- NED (60% vs. 60%), RD (40% vs. 40%). Tumor response was not significantly different in the two groups with respect to age distribution, rural/ urban distribution, histopathological distribution and treatment interruption (*No Evidence of Disease **Residual Disease). Conclusion: Three weekly cisplatin, concomitant with radiation seems to be the potential, effective and acceptable alternate as standard of treatment for locally advanced carcinoma cervix; especially for increased work load and limited resource facilities.