Journal britannique de recherche Libre accès

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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 Chinnikat

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