Concomitant chemotherapy and radiotherary in locally advanced cervical cancer

ABSTRACT

Radiotherapy has been the standard therapy for locally advanced cervical cancer for decades. Neoadjuvant chemotherapy had failed to improve survival in these patients. Concomitant combination of chemotherapy and radiotherapy is promising in improving survival in many clinical trials with risk of increasing radiation reactions. We report a study comparing the combination of weekly cisplatin concomitant with irradiation versus irradiation alone in the same dose and technique. Sixty patients with cervical cancer [stage JIB-I VA] were randomized into two arms; either weekly cisplatin 40 mg/m2 plus radiotherapy [group A] or radiotherapy 45 Gy whole pelvis followed by intracavitary irradiation [to raise the dose to point A to 80 Gy] then parametrial irradiation with central shield for another 15 Gy [group B]. There was a significant difference in response to treatment in both arms [90% Vs. 69% respectively F<0.05]. Also, there was a statistically superior progression free and overall survival in the concomitant group [P<0.043 and p<0.0336]. The toxicity reported was generally limited in both groups and of lower grade despite being significantly higher in patients who received combination treatment. We conclude that combined modality is feasible and could be well tolerated in our patients population