Assessment of Response Rate and Toxicity in Locally Advanced Squamous Cell Carcinoma Cervix with Induction Chemotherapy Followed by Radiotherapy in Comparison with Concurrent Chemoradiation

Abstract

Objective: To compare the toxicity, response rate, and survival of concurrent chemo radiotherapy and induction chemotherapy followed by radiotherapy alone in squamous cell cervical cancer patients.

Place and duration of study: Radiation Oncology Department of Nishtar Hospital for 1 year

Study design: A comparative retrospective study

Methodology: A total of 60 women were included in the study who have been diagnosed with stage IB2 to stage IIIB squamous cell cervical carcinoma. After passing the inclusion and exclusion criteria, patients were divided into two groups, a concurrent chemo radiotherapy group (30 patients) and a radiotherapy group (30 patients) by consecutive data sampling.

      All the patients were subject to external beam radiotherapy to the 45 Gy to whole pelvis with 15 MV X-rays 5 days/week by using the four-field technique. The patients in the radiotherapy group were given induction chemotherapy with cisplatin 50 mg/m2 every 21 days with paclitexal 175mg/m2 (2 cycles) followed by radiotherapy alone. For the patients of concurrent chemo radiotherapy, patients were administered 40 mg/m2 cisplatin weekly with radiations for 5 cycles.

Results: The overall response rate for CCRT group and RT group was 65% (n=30) and 50% (n=30) respectively. The overall survival rate was 12 months and 8 months for the CCRT group and RT group respectively. Similarly, relapse-free survival was 10 months in CCRT patients and 6 months in RT patients. The rate of hematological toxicities was more in CCRT patients. The most common adverse effect was diarrhea with 3 (10%) patients in the CCRT and 2 (6.6%) patients in the RT group. No deaths occurred due to treatment.

Conclusion: The efficacy and toxicity of CCRT show promising results in squamous cell cervical carcinoma patients as compared to induction chemotherapy followed by radiotherapy treatment alone.

Keywords: Concurrent chemoradiotherapy. Radiotherapy, squamous cell cervical carcinoma, toxicity