Concurrent Chemoradiation for Cancer of the Cervix: Results of a Multi-Institutional Study From the Setting of a Developing Country (India)

Abstract

PurposeThe primary output of hospital-based cancer registries is data on cancer stage and treatment-based survival that can be used to evaluate patient care, but because there are many challenges in obtaining follow-up details, a separate study on patterns of care and patterns of survival for patients at selected sites was initiated under the National Cancer Registry Programme of India. This article presents the results for cervical cancer.Patients and MethodsA standardized patient information form was used to record patient information, and data were entered into a central repository—the National Centre for Disease Informatics and Research. The study patients were from 12 institutions and were diagnosed between January 1, 2006, and December 31, 2008. Patterns of treatment were assessed for 7,336 patients, and patterns of survival were determined for 2,669 patients from six institutions, at least 70% of whom had data regarding follow-up as of December 31, 2012.ResultsOf 7,336 patients, 55.5% received optimal radiotherapy (RT). In all, 80.9% of patients had locally advanced cancers (stage IIB to IVA), 51.1% received RT alone, and 44.4% received concurrent chemoradiation (RTCT). In 1,753 patients with locally advanced cancers, significantly better survival was observed with RTCT than with RT alone (5-year cumulative survival, 70.2% v 47.3%; hazard ratio, 0.48; 95% CI, 0.41 to 0.56).ConclusionA conservative estimate indicates that, on an annual basis, 38,771 patients with cervical cancers in India alone do not get the benefit of RTCT and thus they have poorer survival. There is a need to reiterate the National Cancer Institute's alert that advised supplementing chemotherapy to radiation for locally advanced cancer of the cervix in the context of the developing world, where 84.3% of cancers of the cervix occur.

Cost‐effectiveness of human papillomavirus vaccination for adolescent girls in Punjab state: Implications for India's universal immunization program

“…19 The percentage of patients with cancer who received treatment at public or private facilities was estimated using the data from the 71st round of the National Sample Survey. 21 In the control scenario, which implies no HPV vaccination, only the cost of treatment for cervical cancer was considered. Finally, there was significant heterogeneity of treatment of cancer in terms of treatment using surgery, chemotherapy, and radiotherapy.…”

“…We used patterns of stage-wise cervical cancer treatment delivered to patients at the Post Graduate Institute of Medical Education and Research in Chandigarh, which to our knowledge also is the largest hospital registry for cancer in this region. 21 In the control scenario, which implies no HPV vaccination, only the cost of treatment for cervical cancer was considered. All the costs were reported in INR and the values were converted to USD as well as Int$ using USD and purchasing power parity conversion rates for the year 2015, respectively.…”

In vitro Antioxidant and Cytotoxic Effects of Methanol Extracts of Vitex negundo, Lantana camara, Bauhinia variegata and Barringtonia racemosa on Human Cancer Cell lines

“…As shown in figs. 4 Table 4. Many anticancer drugs derived from plants were useful clinically include vinblastine irinotecan, topotecan and paclitaxel [31,32] .…”

“…It is believed that in the upcoming years the number of cancer patients would increase in the emerging and underdeveloped countries up to 70% to become an issue of serious concern. In India, lung, breast, colon, rectum, stomach and liver cancers are frequently detected [4][5][6] .…”

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

“…Poor compliance and enhanced acute toxicity are reported in patients from a rural and underprivileged background in LMICs [34]. Audits from developing countries report 42e85% compliance to planned chemoradiation schedules, with a substantial majority of patients receiving less than five cycles of concurrent chemotherapy [29,35,36]. The coexistence of HIV infection within high incidence regions is also associated with reduced odds of receiving concurrent chemotherapy.…”