Treatment Modality with Concurrent Chemo-Radiation for Locally Advanced Carcinoma Cervix, Four Field Technique EBRT Is Better Responsive than Two Field Technique

Abstract

Background: Carcinoma of the cervix is the fourth most common cancer in women in the world.In 2018,an estimated 570000 women were diagnosed with cervical cancer worldwide and about 311000 women died from the disease. Bangladesh has the highest level of incidence and mortality rates due to cervical cancer among women due to lack of screening, high prevalence of risk factors and poor socio-economic condition. Methods: In this prospective observational study total 90 number of subjects were enrolled to compare the effectiveness of external beam radiation therapy by four field box technique versus two field technique in the treatment of locally advanced carcinoma of uterine cervix. Clinically and histologically diagnosed squamous cell carcinoma of uterine cervix patients were selected as study population. Results: In this study the highest number of patients were in between 46 to 55 years. Most of the subject used Oral contraceptive pill more than 5 years. Most of the patients were in stage IIB.Most of the patients were presented with postcoital bleeding, anemia, vaginal discharge , loss of appetite , Intermenstrual bleeding and pelvic pain. After completion of treatment follow-up per vaginal examination revealed that 73.33% subjects had complete response in four field group (Arm A). In two field group (Arm B), 57.78% had complete response. Common toxicities related to treatment were nausea, vomiting, diarrhea, skin reaction, anemia, leucopenia, bladder toxicity and rectal toxicity. Conclusion: From this study it can be concluded that four field box technique in EBRT was statistically effective in relieving symptoms and achieving complete response than two field technique in the treatment of locally advanced carcinoma of uterine cervix.