CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2018; 39(04): 467-472
DOI: 10.4103/ijmpo.ijmpo_89_17
Original Article

Weekly versus Tri-weekly Cisplatin Concurrent with Radiotherapy in the Treatment of Locally Advanced Carcinoma Cervix: A Prospective Study

Bhaskar Sandeep
Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
,
Jain Sandeep
Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
,
Rastogi Kartick
Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
,
Bhatnagar Aseem-Rai
Department of Radiation Oncology, Shalby Hospital, Jaipur, Rajasthan, India
,
Sharma Neeraj
Department of Radiotherapy, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
› Author Affiliations
Financial support and sponsorship Nil.

Abstract

Context: Different schedules of concurrent chemotherapy with definitive radiotherapy in locally advanced carcinoma cervix. Aims: The aim is to evaluate toxicity, compliance, and response of weekly versus tri-weekly cisplatin given concurrently with radiotherapy in locally advanced squamous cell carcinoma cervix. Subjects and Methods: One hundred and ten newly diagnosed histopathologically confirmed squamous cell carcinoma cervix patients with International Federation of Gynecologists and Oncologists stage IIB to IVA were randomly distributed among study group receiving 75 mg/m2 of cisplatin every 3 weeks for three cycles and control group receiving 40 mg/m2 of weekly cisplatin for six cycles. Results: Patients in both the arms tolerated treatment well. At the time of completion of chemoradiotherapy, 83.63% of patients of the study group and 80% of the control group had a complete response whereas 16.37% of study and 20% of the control group had a partial response, both statistically insignificant (P > 0.05). Compliance was similar in both the groups. The average time to complete radiotherapy was 54.63 days in the study group and 51.34 days in the control group. In the study group, 87.27% of patients completed all cycles of tri-weekly chemotherapy, whereas, in control group, 80% completed all 6 cycles of weekly chemotherapy. The difference was not statistically significant (P = 0.30). Toxicity in terms of vomiting, grade 3–4 leukopenia and neutropenia were more in the study group which was statistically significant (P < 0.001, P = 0.04, and P = 0.03, respectively). Conclusions: Although the 3-weekly cisplatin schedule has longer intervals and sounds convenient, the weekly cisplatin regime shows lower hematologic toxicity with similar disease response and compliance.



Publication History

Article published online:
17 June 2021

© 2018. 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/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 National cancer registry programme. Indian council of medical research, three year report of population based cancer registries 2012-2014, Incidence, Distribution, Trends in Incidence Rates and Projections of Burden of Cancer. Bengluru:India 2016; 2: 9-26 Available from: http://www.ncrpindia.org/ALL_NCRP_REPORTS/PBCR_REPORT_2012_2014/ALL_CONTENT/PDF_Printed_Version/Chapter2_Printed.pdf. [Last accessed on 2017 Jul 15].
  • 2 Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C. et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://www.globocan.iarc.fr/factsheet.asp. [Last accessed on 2017 Oct 17].
  • 3 Viswanathan AN. Uterine Cervix. In: Halperin EC, Wazer DE, Perez CA, Brady LW. editor Principles and practice of radiation oncology. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2013: 1355-9
  • 4 Rose PG, Bundy BN, Watkins EB, Thigpen JT, Deppe G, Maiman MA. et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 1999; 340: 1144-53
  • 5 Perez CA, Grigsby PW, Castro-Vita H, Lockett MA. Carcinoma of the uterine cervix. I. Impact of prolongation of overall treatment time and timing of brachytherapy on outcome of radiation therapy. Int J Radiat Oncol Biol Phys 1995; 32: 1275-88
  • 6 Chen SW, Liang JA, Yang SN, Ko HL, Lin FJ. The adverse effect of treatment prolongation in cervical cancer by high-dose-rate intracavitary brachytherapy. Radiother Oncol 2003; 67: 69-76
  • 7 Nag S, Erickson B, Thomadsen B, Orton C, Demanes JD, Petereit D. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 2000; 48: 201-11
  • 8 Keys HM, Bundy BN, Stehman FB, Muderspach LI, Chafe WE, Suggs 3rd CL. et al. Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med 1999; 340: 1154-61
  • 9 Morris M, Eifel PJ, Lu J, Grigsby PW, Levenback C, Stevens RE. et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med 1999; 340: 1137-43
  • 10 Whitney CW, Sause W, Bundy BN, Malfetano JH, Hannigan EV, Fowler Jr. WC. et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: A Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol 1999; 17: 1339-48
  • 11 Green JA, Kirwan JM, Tierney JF, Symonds P, Fresco L, Collingwood M. et al. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: A systematic review and meta-analysis. Lancet 2001; 358: 781-6
  • 12 Green J, Kirwan J, Tierney J, Vale C, Symonds P, Fresco L. et al. Concomitant chemotherapy and radiation therapy for cancer of the uterine cervix. Cochrane Database Syst Rev 2005; 3: CD002225
  • 13 Serkies K, Jassem J. Concurrent weekly cisplatin and radiotherapy in routine management of cervical cancer: A report on patient compliance and acute toxicity. Int J Radiat Oncol Biol Phys 2004; 60: 814-21
  • 14 Kato S, Ohno T, Thephamongkhol K, Chansilpa Y, Yuxing Y, Devi CR. et al. Multi-institutional phase II clinical study of concurrent chemoradiotherapy for locally advanced cervical cancer in East and Southeast Asia. Int J Radiat Oncol Biol Phys 2010; 77: 751-7
  • 15 Ryu SY, Lee WM, Kim K, Park SI, Kim BJ, Kim MH. et al. Randomized clinical trial of weekly vs. triweekly cisplatin-based chemotherapy concurrent with radiotherapy in the treatment of locally advanced cervical cancer. Int J Radiat Oncol Biol Phys 2011; 81: e577-81
  • 16 Chumworathayi B, Suprasert P, Charoenkwan K, Srisomboon J, Phongnarisorn C, Siriaree S. et al. Weekly versus three-weekly cisplatin as an adjunct to radiation therapy in high-risk stage I-IIA cervical cancer after surgery: A randomized comparison of treatment compliance. J Med Assoc Thai 2005; 88: 1483-92
  • 17 Ikushima H, Osaki K, Furutani S, Yamashita K, Kawanaka T, Kishida Y. et al. Chemoradiation therapy for cervical cancer: Toxicity of concurrent weekly cisplatin. Radiat Med 2006; 24: 115-21
  • 18 Kim YS, Shin SS, Nam JH, Kim YT, Kim YM, Kim JH. et al. Prospective randomized comparison of monthly fluorouracil and cisplatin versus weekly cisplatin concurrent with pelvic radiotherapy and high-dose rate brachytherapy for locally advanced cervical cancer. Gynecol Oncol 2008; 108: 195-200
  • 19 Toita T, Moromizato H, Ogawa K, Kakinohana Y, Maehama T, Kanazawa K. et al. Concurrent chemoradiotherapy using high-dose-rate intracavitary brachytherapy for uterine cervical cancer. Gynecol Oncol 2005; 96: 665-70