Pure Accelerated Radiation Versus Concomitant Chemoradiation in Selected Cases of Locally Advanced Carcinoma Cervix: A Prospective Study

Abstract

This non-randomized study was conducted to assess and compare the response and safety of true accelerated radiation alone to concomitant chemoradiation in locally advanced squamous cell carcinoma of the uterine cervix. Sixty patients with locally advanced squamous cell carcinoma of the uterine cervix, FIGO Stages (2009) IB2-IIIB were non-randomized to receive six fractions per week of external beam radiation (EBRT) (will be henceforth referred to as Arm A or Study arm or pure accelerated radiation arm) and five fractions per week of EBRT and chemotherapy with inj cisplatin 40mg/m(2) i.v. every Monday during the course of EBRT (will be henceforth referred to as Arm B or Control arm or chemoradiation arm). The median follow-up was 15months in both the arms. The overall treatment time was 56.54days for Arm A and 62.59days for patients in Arm B (P value<0.000**). The median EBRT time was 32.25days in Arm A and 38.85days in Arm B, a statistically significant delay for patients of chemoradiation Arm B (P value<0.000**). The response assessment at the end of the study was not statistically different among the patients in both the treatment arms (P value 0.631). The early responses to treatment with pure accelerated EBRT are non-inferior to concomitant chemoradiation and the acute toxicities are lesser.