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.
Concomitant Chemoradiation versus Accelerated Radiotherapy in Selected Cases of Locally Advanced Carcinoma Cervix – A Prospective Study