“The effect of treatment prolongation in treatment of cervical cancer patient” –treated patients at rural center in India”

Abstract

Introduction: The potential risk of prolongation of treatment time in cervical cancer has been reported for many low-dose rate (LDR) studies, with an estimated loss of local control ranging from 0.3 to 1.6% per day of treatment prolongation. Since the treatment schedule for fractionated high-dose rate intracavitary brachytherapy (HDRICBT) is not directly comparable with that for LDR studies. Many studies are also present with different results. Aims: To evaluate the adverse effect of treatment prolongation for cervical cancer treated with HDRICBT. Methods and Materials: Hundred patients with biopsy proven squamous cell carcinoma of the cervix with stage IIB to IVA (according to FIGO classification) were entered into protocol using concurrent paclitaxel and radiation. Radiotherapy was conventionally administered: 50.4 Gy/28 fractions by external beam (whole pelvis) followed by HDR-ICBT, 4 fractions of 7 Gy each. Paclitaxel was administered on weekly basis at dose of 40 mg∕m 2 during entire course of external beam radiotherapy. Results: Treatment response was evaluated three months after the end of radiotherapy by means of clinical examination and ultrasonography. Complete Regression (CR) in 83%, partial response (PR) 14% and progressive disease 3%. At 26 months of median follow up 73 patients alive out of 58 patients are diseases free. Conclusion: The results of this study suggest that to achieve better treatment outcome, avoid treatment prolongation and overall treatment time should be less than 50 days.