Concurrent Weekly versus Three Weekly Cisplatin with Radiotherapy in Locally Advanced Uterine Cervical Carcinoma

Uterine cervical carcinoma is the commonest form of gynecological malignancy in Bangladesh as well as in South Asia. Outcome of weekly versus three weekly Cisplatin concurrent with External beam radiotherapy followed by intracavitary radiotherapy in locally advanced cervical carcinoma was compared in this study.

A quasi experimental study was carried out from April 2016 to September 2017. Total eighty patients of uterine cervical cancer were included and received External beam radiotherapy concurrent with either weekly or three weekly Cisplatin followed by High dose rate intracavitary brachytherapy. External beam radiotherapy was given with a dose of 50 Gray (Gy) in conventional fractionation over 5 weeks. Cisplatin 40 mg/m2, weekly was given along with radiotherapy to the patients of Arm A (n=40) while the patients of Arm B (n=40) received cisplatin 75 mg/m2, 3 weekly along with the radiotherapy. Patients were evaluated weekly during treatment and afterwards up to 6 months.

The mean age of patients were 48±9 years for Arm A and 42±9 years for Arm B. Complete response at 6 months of follow up was observed in 30 (75%) and 36 (90%) patients of Arm A and B respectively.Overall complete response was observed in 66 (82.5%)patients. Common toxicities were nephrological, hematological, skin and bowel related and were managed accordingly. Grade III-IV neutropenia was more in patients of Arm A (42.5%) than B (20%).

This study showed that the radiotherapy concurrent with three weekly Cisplatin is effective and less toxic than weekly Cisplatin in locally advanced cervical carcinoma.