Objective: To evaluate the efficacy of cisplatin-based concurrent chemoradiation in squamous cell carcinoma of cervix and the frequency of acute toxicity.
Study design: Case series.
Place and duration of study: Department of Clinical Oncology, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN), Karachi, from September 2010 to September 2011.
Methodology: Eighty patients with histologically proven squamous cell carcinoma of cervix were included. Patients were treated with concurrent chemoradiation. External beam radiation was delivered with 50 Gy whole pelvis along with 40 mg/m2 weekly cisplatin followed by brachytherapy three insertions of 6.5 Gy each, one week apart. Response to treatment was assessed using response evaluation criteria in solid tumours (RECIST) criteria at 4 weeks after treatment. Acute toxicity of chemoradiation was assessed using common toxicity criteria.
Results: Out of the 80 patients, 8 patients were lost to follow-up. Remaining 72 patients aged 28 - 65 years with mean age of 48.03 ±8.9 years. Forty-eight patients (66%) were in stage II-B, 5 (7%) were in stage III-A, 7 (10%) were in stage III-B, and 12 (17%) were in stage IV-A. Overall response to treatment was 92%, in which 39 (54%) had complete response, and 27 (38%) had partial response while 6 (8%) show progressive disease. About 70% patients had diarrhea, 61.2% patients developed vomiting, 45.8% patients had dermatitis, 43% patients had vaginal mucositis, 40.3% had anemia, 13.9% patients had neutropenia, 27.8% patients had dysuria, and 22.2% patients had proctitis.
Conclusion: Cisplatin-based concurrent chemoradiation is an effective treatment in locally advanced stage of cervical cancer with manageable toxicity.