scholarly journals Comparative evaluation of concomitant chemoradiation with weekly cisplatin and gemcitabine versus weekly cisplatin in the management of locally advanced carcinoma of uterine cervix

2016 ◽  
Author(s):  
Vikas Gupta ◽  
Ashok Kumar Chauhan ◽  
Paramjeet Kaur ◽  
Anil Khurana ◽  
Yashpal Verma ◽  
...  
Keyword(s):  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Definitive Treatment ◽  
High Dose ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma ◽  
Group I ◽  
Concomitant Chemoradiation ◽  
Group Ii ◽  
Weekly Cisplatin

Aim: To evaluate feasibility of concomitant chemoradiation with weekly cisplatin and gemcitabine, and comparing the advantage of using this regimen over cisplatin alone in terms of disease control and toxicities in management of locally advanced carcinoma cervix. Materials and Methods: The study has been conducted on fifty previously untreated, histopathologically proven FIGO stage II B - IV A patients of carcinoma cervix, attending the Department of Radiotherapy, Post Graduate Institute of Medical Sciences, Rohtak for definitive treatment by radiation therapy. The patients were divided randomly in two groups of 25 patients each. Group I received cisplatin 40 mg/m2 and gemcitabine 125 mg/m2 with concomitant external beam radiotherapy 50 Gy/25 fractions/5 weeks, followed by intracavitary high dose rate brachytherapy 7 Gy to point A, for 3 times, once in a week. Group II received concomitant chemotherapy with cisplatin 40 mg/m2 weekly alone while radiotherapy schedule were same as in group I. Results: Total treatment duration in group I and II were 9-11 and 8-10 weeks respectively. Complete response rate in group I and II were 92% and 80%. Grade III skin and mucosal reactions was 20% in group I and none in group II. Diarrhoea was 24% in group I & 8% in group II. Grade II & III leucopenia was seen in 28% and 4% cases of group I & group II respectively. Upper gastrointestinal and renal toxicities were comparable in both arms. After six month of follow up, no evidence of disease was seen in 92% and 80% cases of group I and group II. Conclusion: If the toxicity is managed adequately in platinum based doublet group, it may produce improvement in response. Study is ongoing.

scholarly journals Weekly versus biweekly high-dose rate brachytherapy schedules in carcinoma cervix following concomitant chemoradiation with paclitaxel and carboplatin

2017 ◽  
Vol 03 (01) ◽  
pp. 012-016
Author(s):  
Pooja Gogia ◽  
Anil Dhull ◽  
Vivek Kaushal
Keyword(s):  
Dose Rate ◽  
High Dose Rate ◽  
High Dose ◽  
Weekly Schedule ◽  
Hdr Brachytherapy ◽  
Concomitant Chemotherapy ◽  
Carcinoma Cervix ◽  
Group I ◽  
Concomitant Chemoradiation ◽  
Group Ii

Abstract Context: In the management of cervical cancer, though a number of chemotherapeutic drugs have been used for concomitant chemoradiation, paclitaxel and carboplatin have shown improved overall response rates with acceptable side effects. The use of intracavitary irradiation significantly improves survival and reduces local failures. However, the ideal time-dose-fraction schedule remains controversial with high-dose rate (HDR) brachytherapy. Aims: The aim of this study was to determine the efficacy and safety of paclitaxel and carboplatin for concomitant chemoradiation therapy and to compare the local control, toxicity, and tolerability of the two HDR brachytherapy schedules in patients of carcinoma cervix. Subjects and Methods: The patients were divided randomly into two groups of thirty patients each. Both the groups were treated with a combination of external beam radiotherapy with 50 Gy/5 weeks/25 fractions to whole pelvis along with concomitant chemotherapy. The concomitant chemotherapy schedule was injection paclitaxel (135 mg/m2) and injection carboplatin (area under the curve - 4.5 mg min/ml) at 4-week interval followed by HDR brachytherapy. Following which, patients received HDR-intracranial brachytherapy on the basis of random allocation, Group I: 6 Gy × 3 fractions (weekly) and Group II: 5 Gy × 4 fractions (biweekly). Results and Conclusion: The survival difference between the two groups (weekly and biweekly) was not statistically significant. However, Grade 2–3 rectal reactions in Group I were significantly higher than Group II (P = 0.038). The twice-weekly schedule of brachytherapy was a significant factor influencing the late complication rate but not the local pelvic control rate or overall survival rate.

8048 Weekly cisplatin or gemcitabine concomitant with radiation in management of locally advanced carcinoma cervix

2009 ◽  
Vol 7 (2) ◽  
pp. 463-464
Author(s):  
A.K. Verma ◽  
M. Kumar ◽  
A.K. Arya ◽  
A. Kumar ◽  
D.N. Sharma ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma ◽  
Weekly Cisplatin

A PROSPECTIVE RANDOMIZED STUDY TO COMPARE THE CONCURRENT CHEMO-RADIATION VERSUS HYPO-FRACTIONATED CHEMO-RADIATION IN LOCALLY ADVANCED CERVICAL CANCER.

2021 ◽  
pp. 40-42
Author(s):  
Arpan Jana ◽  
Pabitra Das ◽  
Poulami Gupta ◽  
Phalguni Gupta
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Intracavitary Brachytherapy ◽  
External Beam ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma

Background: Concurrent chemo-radiation is the standard treatment worldwide for locally advanced squamous Cell carcinoma cervix. However, conventional chemo-radiotherapy is also associated with unacceptable local and systemic failure rates for locally advanced disease. Biologically squamous cell carcinoma of head- neck cancer and cervical cancer behaves quite similarly in response to radiotherapy. So, it can be expected that, altered fractionation can increase the local control in case of squamous cell carcinoma cervix than conventional radiotherapy. There is no randomised control trial for carcinoma cervix till date, which compares conventional chemo-radiation with hypo-fractionated chemo-radiation. Aims And Objectives: The present study was planned to compare local disease control and acute toxicity of conventional chemo-radiation with hypo-fractionated chemo-radiation in locally advanced carcinoma cervix. Materials And Methods: In Conventional Chemo-radiation Arm A patients (n=30) received external beam radiotherapy 50 Gy in 25 fractions in 5 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 7 Gy per fraction once in a week for 3 weeks. The second group of hypo-fractionated Arm B received external beam radiotherapy 45 Gy in 20 fractions in 4 weeks accompanied by weekly intravenous Cisplatin 40mg/m2 followed by intracavitary brachytherapy 9 Gy per fraction once in a week for 2 weeks. Results: Grade II diarrhea were seen more in Arm B 17 (56.66%) compare to Arm A 12(40%) and grade III diarrhea was seen 4 (3.33%) in Arm B and 2(6.66%) in Arm A. At 2 months and 6 months after completion of treatment Complete response were 25 (83.4%) in Arm A compare to 22 (73.3%) in Arm B and 20 (74.1%) in Arm A and 18 (72%) in Arm B respectively. Conclusion: Hypo-fractioned radiotherapy may be used as an alternate protocol for treatment of locally advanced carcinoma cervix with acceptable toxicities.

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