Assessment of response to weekly cisplatin-based hypofractionated radiotherapy in carcinoma of cervix
Journal Title: Medpulse International Journal of Radiology - Year 2018, Vol 7, Issue 1
Abstract
Background: External beam radiotherapy along with concurrent weekly cisplatin followed by brachytherapy is the standard practice for managing advanced carcinoma cervix. Hypofractionated radiotherapy in carcinoma of cervixis more convenient for patients and is of benefit in resource constraint health systems. Aim: To assess the response to weekly cisplatin-based hypofractionated radiotherapy in carcinoma of cervixas compared to conventional treatment protocol. Material and Methods: In thishospital based prospective comparative study, 60 patients with carcinoma cervix were equally divided into Arm-A and Arm-B groups. In Arm-A, 30 patients were treated with conventional fractionated radiotherapy (CFR) with weekly inj. Cisplatin 35mg/m2i.v. where, the EBRT of total dose 50Gy (Gray) in 25 fractions, 200cGy (centigray) per fraction daily for 5 days a week was given. In Arm-B, 30 patients were treated with hypofractionated radiotherapy (HF) with weekly inj. Cisplatin 35mg/m2i.v. where, the EBRT of total dose 42Gy in 15 fractions, 280cGy per fraction on alternate day for 3 days a week was given.Patient evaluation consisted of subjective response to the symptoms, ECOG score, objective response using RECIST 1.0 criteria and treatment complications of chemoradiotherapy. Results: 66.67% patients in Arm-A and 60% patients in Arm-B had complete response. Partial response was seen in 23.33% patients in conventional arm and 30 % patients in hypofractionated arm (p=0.559). Stable disease was seen in 10 % patients each in conventional arm and hypofractinated arm (p=1.000). No patient in conventional arm or hypofractionated arm had progressive disease. Treatment complications like proctitis, cystitis, nausea and vomiting, were statistically more common with hypofractionation. Conclusion: Hypofractionated radiotherapy can be considered in selected group of patients where local disease is extensive and unsuitable for conventional fractionation.
Authors and Affiliations
Mahesh Rewadkar
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