Abstract
Context: Different schedules of concurrent chemotherapy with definitive radiotherapy in locally
advanced carcinoma cervix. Aims: The aim is to evaluate toxicity, compliance, and response of weekly versus tri-weekly
cisplatin given concurrently with radiotherapy in locally advanced squamous cell carcinoma
cervix. Subjects and Methods: One hundred and ten newly diagnosed histopathologically confirmed squamous cell carcinoma
cervix patients with International Federation of Gynecologists and Oncologists stage
IIB to IVA were randomly distributed among study group receiving 75 mg/m2 of cisplatin every 3 weeks for three cycles and control group receiving 40 mg/m2 of weekly cisplatin for six cycles. Results: Patients in both the arms tolerated treatment well. At the time of completion of
chemoradiotherapy, 83.63% of patients of the study group and 80% of the control group
had a complete response whereas 16.37% of study and 20% of the control group had a
partial response, both statistically insignificant (P > 0.05). Compliance was similar in both the groups. The average time to complete
radiotherapy was 54.63 days in the study group and 51.34 days in the control group.
In the study group, 87.27% of patients completed all cycles of tri-weekly chemotherapy,
whereas, in control group, 80% completed all 6 cycles of weekly chemotherapy. The
difference was not statistically significant (P = 0.30). Toxicity in terms of vomiting, grade 3–4 leukopenia and neutropenia were
more in the study group which was statistically significant (P < 0.001, P = 0.04, and P = 0.03, respectively). Conclusions: Although the 3-weekly cisplatin schedule has longer intervals and sounds convenient,
the weekly cisplatin regime shows lower hematologic toxicity with similar disease
response and compliance.
Keywords
Cervical cancer - concurrent chemoradiation - Cisplatin - external-beam radiotherapy
- International Federation of Gynecology and Obstetrics - high dose rate intracavitary
brachytherapy
