Evaluation of Role of Concurrent Chemotherapy and Brachytherapy in Locally Advanced Cervical Cancer Patients

Abstract

Aim: Carcinoma of Uterine cervix is the commonest cancer affecting females in developing countries. Concurrent chemoradiation has remained the sole definitive treatment available in the advanced stages. The study was planned to take the advantage of radiosensitisation accruing due to chemotherapy at the time of brachytherapy, when approximately forty percent of total tumor dose is applied. Materials and methods:64 patients were enrolled who had locally advanced uterine cervix carcinoma (FIGO stage IIB to IVA) from July 2011 to May 2013 for concurrent chemotherapy and intracavitory brachytherapy after completion of concurrent chemotherapy and external beam radiotherapy followed by 3 insertion of brachytherapy separated by a week by Flexitron brachytherapy unit to point A, for each application was 6 Gy by HDR. Cisplatin was given (35 mg/m 2 ) one day before brachytherapy in each application. Results:At medium follow-up of 19 months (range 8 to 30 months) clinical complete response rate was found to be 89% at 3 months of follow up. Acute side effect as nausea and vomiting grade I and II were recorded as 55% and 28% respectively, no renal dysfunction and no thrombocytopenia were encountered. No patients had grade IV or life threatening toxicity. Overall survival and disease free survival after 30 months of follow up is 88% and 75% respectively. Conclusion:Use of concurrent chemotherapy with brachytherapy is effective and feasible with acceptable toxicity for locally advanced carcinoma of the uterine Cervix.