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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2008; 29(04): 12-18
DOI: 10.4103/0971-5851.51399
Original Article

Chemoradiation in locally advanced cervical cancer : A randomized trial

Sayan Kundu
Department of Radiotherapy, Medical College Hospital, Kolkata-700073, India
,
S Basu
Department of Radiotherapy, Medical College Hospital, Kolkata-700073, India
,
S Acharya
Department of Radiotherapy, Medical College Hospital, Kolkata-700073, India
,
A Dastidar
Department of Radiotherapy, Medical College Hospital, Kolkata-700073, India
,
A G Roy
Department of Radiotherapy, Medical College Hospital, Kolkata-700073, India
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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.



Publication History

Article published online:
19 November 2021

© 2008. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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