Title: Long Term Outcome after Concurrent Chemo radiation with Cisplatin in Carcinoma Cervix
Authors: Dr Preeya.V, Dr Manoj .S, Dr Rema.P.L, Dr Anu Asokan, Mrs Ance Joseph
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.03
Abstract
Aim: The aims of this study were to examine treatment outcomes (survival, local control and toxicity) in patients with cervical cancer treated with chemoradiation in stage 1B2-1VA carcinoma of cervix in Department of Radiotherapy, Government Medical College, Kottayam.
Materials and Methods: Between January 2012 to December 2013, 46 patients with cervical cancer were treated with chemoradiation. Case notes were reviewed retrospectively. Acute and late toxicity were recorded, with toxicity graded using the Common Toxicity Criteria Version 4. The mean age was 56 years. All patients were staged with examination under anaesthesia by FIGO staging. The chemotherapy used was cisplatin 40 mg/m2 weekly with radiotherapy. External beam radiotherapy was given to the pelvis (45-46 Gy/23 fractions/4 1/2weeks) followed by high dose rate brachytherapy (18 Gyto point A, 9 Gy per fraction weekly in 2 fractions). Optimal dose of radiation (ORT) was defined as a minimal cervical dose exceeding 70 Gy, point A dose of 80–90 Gy, and duration not exceeding 56 days. Optimal dose of radiation was received by 45.7% of patients. Bulky disease, anaemia, advanced stage, non optimal radiation dose and prolonged treatment time affected local failure rate.
Results: The 3-year overall survival rate was 93.5%. The 3-year disease-free survival was 87%.. There were 5 patients (10.9%) with acute toxicities and 21cases (45.8%) of chronic toxicities. Local failure rate was 4.3%
Conclusion: There was a trend towards improved survival and local control with concurrent chemoradiation in this cohort of patients that may become significant with longer follow-up. Patients with anaemia, bulky and locally advanced, cervical cancer treated with weekly cisplatin, teletherapy, and high dose-dose rate brachytherapy have poorer outcomes when treatment duration is prolonged.
Keywords: Cervix carcinoma, chemoradiotherapy, outcome, survival, toxicity.
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