A comparative study on weekly versus three weekly cisplatin based concurrent chemoradiotherapy in treatment of carcinoma cervix; Patient compliance and Feasibility study

Abstract

Background: This prospective study  compare concurrent weekly and three weekly cisplatin based concurrent chemoradiotherapy in locally advanced cervical cancer.Methods: The study was conducted in 40 patients with locally advanced carcinoma cervix  randomised into 2 arms. Arm A patients received external beam Radiotherapy (EBRT) to pelvis with concurrent weekly cisplatin at dose of 40 mg/m2 and arm B patients received EBRT to pelvis with concurrent three weekly cisplatin at dose of 75 mg/m2 followed by high dose rate intracavitary brachytherapy (HDR ICBT). Acute  gastrointestinal (GI) toxicities being common and worrisome complication and response rates were analysed.Results: The patient and disease characteristics were comparable in both arms. There was no significant difference in both arms in terms of lower GI toxicity i.e weekly vs three weekly(75% Vs 80%; P = 0.208) . Compliance to chemoradiation was better in three weekly vs weekly (85% vs 70%) cisplatin arms but not statistically significant (p<0.05) After a median follow up of 18 months, tumor control rates in both arms were comparable (85% Vs 90%; P = 0.128).Conclusion: The present study observations suggest that concurrent weekly or three weekly cisplatin based chemo-radiation therapy is equally effective in treatment of cervical cancer in terms of local tumor control rate,lower GI toxicity and patients compliance to proposed chemoradiotherapy treatment. However randomised trials with larger sample sizes and longer duration of follow up are required.