Concurrent weekly cisplatinum and radical radiotherapy versus radical radiotherapy in patients with locally advanced carcinoma of the cervix

ABSTRACT

Primary end point is to purpose assess the rate of local control for patients with stage IIB-IVA [FIGO] epithelial cervical cancer treated with concomitant weekly cisplatin plus radical radiotherapy compared to a comparable group of patients treated with radical radiotherapy alone. Secondary end points, Diseases free survival, time to progression toxicity profile and overall survival. 60 patients locally advanced carcinoma of cervix [stage lIB, IlIA, IIIB] has been collected and treated with concomitant weekly cisplatin 40-mg/m[2] minutes before radiation plus radical radiotherapy with external radiotherapy 46 Gys in 23 fraction to the whole pelvic followed by single intracavitary brachytherapy insertion using Cs-137 to deliver 40 Gys equivalent to point. A the data was collected and compared to the results of another 60 patients treated with radical radiotherapy alone with same dose EBR and ICR. The incidence of local recurrence and distant metastasis were reduced from 26.6%, 13.3% in group A to 13.3% in group B patients respectively [P = 0.03, P = 0.38]. Disease free and overall survival were higher 76.6% and 85.0% for group B patients compared to 60.0% and 76.6% for group A patients [P = 0.03, P = 0.12]. Time to progression was significantly longer in group B patients compared to group A median 36 months and 18 months respectively. The incidence of a cute treatment toxicity was almost comparable in the two group with group B patients showed slightly higher heamotologic toxicity [P = 0.01]. The results reported in this study showed that concomitant weekly cisplatin plus radical radiotherapy significantly reduce the incidence of pelvic failure and distant metastasis and improve disease free and overlay survival with low toxicity profile in patients with locally advanced carcinoma of cervix