Impact of Induction Chemotherapy Followed by Radiotherapy in Patients of Invasive Cervical Carcinoma with Inadvertent Hysterectomy: A Retrospective Study.

Abstract

The standard of care for patients who undergo an inadvertent hysterectomy for invasive cervical carcinoma is not well established. The aim of this study was to evaluate the role of induction chemotherapy followed by external beam radiotherapy and brachytherapy in patients who had an inadequate hysterectomy for carcinoma of the cervix. Patients with history of inadequate hysterectomy with no residual disease at presentation to our outpatients department of Radiotherapy and registered between October 2011 to June 2014 were retrospectively analyzed. Most of these patients had received three cycles of induction chemotherapy using Paclitaxel and Carboplatin regime. Thereafter, these patients had received external beam radiotherapy and vaginal brachytherapy. The primary end points were overall survival and disease-free survival. Survival analysis was done using Kaplan-Meier method and the differences in survival rates were compared using log-rank test. A total of 34 patients were eligible for the study. Overall survival and Disease-free survival at 3-years were 70% and 68%. Patients who had Taxane-based chemotherapy had significantly better survival outcomes than their counterparts. Vaginal vault boost with brachytherapy had a significant impact on prognosis of these patients. Induction chemotherapy using Paclitaxel and Carboplatin followed by external beam radiotherapy and brachytherapy is a good treatment option for patients of carcinoma of the cervix who have undergone inadvertent hysterectomy.