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A Comparative Study on Response and Toxicity of Concurrent Chemo-Radiotherapy and Radiotherapy Only in the Treatment of Cervical Cancer

HN Ashikur Rahaman and Shravana Kumar Chinnikatti

Introduction: Cervical cancer is the fourth most frequent cancer in women with
an estimated 570,000 new cases in 2018 representing 6.6% of all female cancers.
Approximately 90% of deaths from cervical cancer occurred in low- and middleincome
countries. The high mortality rate from cervical cancer globally could
be reduced through a comprehensive approach that includes prevention, early
diagnosis, effective screening and treatment programmes.
Objective: This experimental study was carried out to compare the response and
acceptable toxicity in concurrent chemo-radiotherapy and radiotherapy only in
the treatment of cervical cancer.
Methods and Materials: The study had conducted in the Department of Radiation
Oncology, Enam Medical College Hospital, Savar, Dhaka and in the Department of
Radiation Oncology, National Institute of Cancer Research and Hospital (NICRH),
Dhaka from July 2018 to June 2019.
Type of Study: Experimental study-Randomized Control Clinical Trial. Patients with
carcinoma cervix attained at the Radiation Oncology Department of EMCH and
NICRH during the study period had included in the study according to the inclusion
of an exclusion criterion.
Results: A total of 80 patients (40 patients in Side A and 40 patients in Side B) who
have biopsy-proven cervical carcinoma with no history of previous treatment were
selected from the Department of radiotherapy Enam Medical College Hospital,
Savar, Dhaka and in the Department of Radiation Oncology, National Institute of
Cancer Research and Hospital. All patients on both sides received external beam
radiation with 50 Gy in 25 daily fractions over five weeks. Followed by three
insertions of Brachytherapy were given by 21 Gy (one insertion per week for 7 Gy).
Patients in Side A received injection Cisplatin 40 mg/m2 in IV infusion on the first
day of each treatment per week in addition to radiotherapy. In this study, it was
observed that a significant symptomatic improvement was found in Side A after
treatment than Side B and no severe unwanted reaction was noted in most of the
patients. Systematic toxicity developed in both groups and comparatively more in
Side A (chemoradiation) but that was not statistically significant and well managed
with conservative treatment. Regarding performance status patients treated with
concurrent chemoradiation showed better performance status than the patient
treated with radiotherapy alone.
Conclusion: In this study, it was observed that patients of carcinoma cervix treated
with concurrent chemoradiotherapy were effective for symptomatic improvement
and suitable with acceptable toxicity for advanced cancer of the uterine cervix
than those with radiation only.