Chemoradiation in locally advanced cervical cancer : A randomized trial

• Published in: Indian journal of medical and paediatric oncology 2008-10, Vol.29 (4), p.12-18
• Main Authors: Kundu, Sayan, Basu, S, Acharya, S, Dastidar, A, Roy, A G
• Format: Article
• Language: English
• Subjects: Cervical cancer; Chemotherapy; Clinical trials; Original Article; Radiation therapy
• ISSN: 0971-5851; 0975-2129
• DOI: 10.4103/0971-5851.51399

Abstract Background: Radiation with concurrent chemotherapy (weekly cisplatin) is currently standard of care for locally advanced cervical cancer. Gemcitabine, a pyrimidine analogue is a potentially radio-sensitizing drug. We compared cisplatin and gemcitabine in the treatment of locally advanced cervical cancer. Methods: 90 patients with locally advanced squamous cell cancer of the cervix (stage IIB-IVA) were randomized to receive either cisplatin 40mg/m2 weekly or gemcitabine 150 mg/m2 weekly (45 patients in each arm) along with external beam radiation (50Gy in 25# over 5 weeks). This was followed by three insertions of high dose radiation (HDR) intracavitary brachytherapy one week apart. Results: At a median follow up of 13months, 25 (55.56%) patients were in complete response (CR) in the cisplatin arm compared to 22 patients (48.89%) [p=0.67] in gemcitabine arm. 10 patients (22.22%) in cisplatin arm had either died or lost to follow up compared to 11 patients in gemcitabine (24.44%) arm. Nausea/vomiting was higher in cisplatin arm. Diarrhea, skin reaction and hematological toxicity were more in gemcitabine arm. Conclusion: Cisplatin seems to be a better option than gemcitabine when used concurrently with radiation for locally advanced cervical cancer both in terms of response and toxicity.