Integration of Consolidation Chemotherapy After Concurrent Chemoradiation in the Treatment of Locally Advanced Uterine Cervical Cancer.

Autor: Haritha VS; Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh India., Singotia L; Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh India., Jain R; Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh India., Saxena AK; Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh India., Rawat S; Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh India., Patel L; Department of Radiation Oncology, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh India.
Jazyk: angličtina
Zdroj: Indian journal of gynecologic oncology [Indian J Gynecol Oncol] 2022; Vol. 20 (4), pp. 70. Date of Electronic Publication: 2022 Nov 19.
DOI: 10.1007/s40944-022-00646-9
Abstrakt: Background: Despite the current standard of concurrent chemoradiation (CCRT), around 30-40% are still dying from locally advanced cervical cancer. Increasing the radiation dose further was not a feasible option, but addition of chemotherapy further was tried due to the different toxicity profiles of it. So, the use of consolidation chemotherapy beyond CCRT has been studied.
Aim: To evaluate the efficacy, toxicity, tumour response and loco-regional control following consolidation chemotherapy after concurrent chemoradiation in locally advanced carcinoma cervix (LACC).
Methods: The patients were randomized into two arms: the conventional arm (control arm, n  = 30) patients received conventional treatment with weekly injection cisplatin (35 mg/m 2 ) concurrently with pelvic external beam radiation (50 Gy/25 fraction, 2 Gy/fraction, 5 fraction weekly) followed by intracavitary radiotherapy of 21 Gy in 3 fractions of 7 Gy each by HDR brachytherapy. In the interventional arm (study arm, n  = 30), patients received the standard treatment followed by 3 cycles of consolidation chemotherapy (paclitaxel + carboplatin) every three weekly.
Results: Haematological toxicity (grade 3 anaemia and grade 1 leucopenia, grade 1 and 2 thrombocytopenia) was higher in the study group. Renal, hepatic and gastrointestinal toxicity was more in the study arm. Peripheral neuropathy was mostly seen in the study arm. Median follow-up was 9 months. Treatment response was better, and the rate of recurrence was less in the study arm.
Conclusion: Addition of few cycles of consolidation chemotherapy after standard treatment is beneficial in patients with LACC with manageable toxicity and good compliance.
Competing Interests: Conflicts of interestNil.
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Databáze: MEDLINE
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