1. Prospective Study To Compare Conventional Chemoradiotherapy With Hypofractionated Chemoradiotherapy In Carcinoma Cervix Prospective Study To Compare Conventional Chemoradiotherapy With Hypofractionated Chemoradiotherapy In Carcinoma Cervix.
- Author
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PRASAD, S. N.
- Subjects
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POSTOPERATIVE nausea & vomiting , *CHEMORADIOTHERAPY , *LONGITUDINAL method , *SQUAMOUS cell carcinoma , *CARCINOMA , *REACTION time - Abstract
BACKGROUND Cervical cancer is the leading cancer in Indian women and the second most common cancer in women worldwide. Even though cancer screening has become prevalent with an aim of early diagnosis and treatment, about 60% of patients still present in late stage. Treatment for advanced stage carcinoma cervix is a combination of external beam radiation and brachytherapy. Conventional external beam radiation delivers a dose of 2Gy per fraction with standard pelvic portals with antero-posterior or box field technique. Overall treatment time has considerable effect on local control and survival. In hypofractionated treatment the overall treatment time is reduced. In our institute, we focused on hypofractionated radiotherapy, which is a modality without additional burden to the, patients. We therefore conducted a clinical study to evaluate the effect of a fraction size of 3 Gy on local control in advanced stage cervical cancer. AIM To evaluate the efficacy in terms of locoregional response & toxicity of a hypofractionated chemoradiation regimen of Carcinoma Cervix vs. Conventional fractionated chemoradiation MATERIALS AND METHODS 52 eligible patients with FIGO stage IIB-IVA non metastatic squamous cell carcinoma Cervix reporting to JKCI OPD were randomly divided into two groups of 26 patients each: GROUP I ? EBRT/ 60 Co / 46 Gy / 23 # / 4½ week /to pelvis o With concurrent cisplatin 40mg/m2 weekly followed by ICRT 6 Gy weekly x 3 weeks GROUP II ? EBRT/ 60 Co / 39 Gy / 13 # / 2 ½ week /to pelvis o With concurrent cisplatin 40mg/m2 weekly followed by ICRT 6 Gy weekly x 3 weeks RESULTS Between January 2014 to July 2015 a total of 52 patients were enrolled, 26 in each group. The median total treatment time in group I was 8 weeks and 6 weeks in group II. Response rate was comparable between two groups, with complete response in group I and group II 73.07% vs. 69.23% respectively. On comparing the incidence of acute toxicity (grade III) nausea and vomiting was 15.38% in group I vs. 23.07% in group II; GI toxicity (grade II/III) was 50% in group I vs. 57.6% in group II. Skin and mucosal toxicities(grade III) were 11.5% in the former group vs. 23.07% in the latter whereas haematological toxicity 20% vs. 23% in group I and group II respectively. CONCLUSION In locally advanced carcinoma cervix hypofractionated radiotherapy with concurrent cisplatin weekly followed by Brachytherapy is a reasonable alternative to the standard fractionated regimen with concurrent cisplatin weekly followed by Brachytherapy offers advantages of decreased overall treatment time with comparable response rate and toxicity profile. Decreased treatment time seems an upper edge in view of work load. [ABSTRACT FROM AUTHOR]
- Published
- 2017