Comparison of Neoadjuvant Chemotherapy Followed by Radical Hysterectomy and Neoadjuvant Chemoradiation Followed by Radical Hysterectomy with Concurrent Chemoradiation in Locally Advanced Carcinoma Cervix (FIGO Stages IB2, IIA2, IIB): Interim Results of a Randomized Control Study
Syed A Hussain, Jagadeesan G Mani
Brachytherapy, Locally advanced cervical cancers, Preoperative chemoradiotherapy, Randomized control trial, Toxicity profile, Quality of life
Citation Information :
Hussain SA, Mani JG. Comparison of Neoadjuvant Chemotherapy Followed by Radical Hysterectomy and Neoadjuvant Chemoradiation Followed by Radical Hysterectomy with Concurrent Chemoradiation in Locally Advanced Carcinoma Cervix (FIGO Stages IB2, IIA2, IIB): Interim Results of a Randomized Control Study. J South Asian Feder Obs Gynae 2019; 11 (1):35-43.
Objectives: To investigate the therapeutic efficacy, toxicity profile and quality of life in locally advanced cervical carcinoma treated with concurrent chemoradiation therapy (CCRT), preoperative chemoradiation (PCRT) and preoperative chemotherapy (PCHEMO) followed by surgical implications
Materials and methods: A total of (N = 100) locally advanced cervical cancer patients (FIGO stages IB2, IIA2 and IIB) was treated between June 2014 to March 2018, Out of 100 patients, 33 patients treated with CCRT arm (50Gy EBRT and 21Gy brachytherapy), 33 patients treated with PCRT arm (50Gy EBRT) followed by radical hysterectomy, 34 patients with PCHEMO arm followed with radical hysterectomy using 3 weekly cisplatin (75 mg/m2 and paclitaxel (175 mg/m2). Patient's Quality life was recorded with a standard questionnaire. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) software version 22.
Results: The median follow-up period was found to be 28 months. However less statistical significance was obtained between various parameters such as age, FIGO stage, performance status, perioperative morbidities, and symptoms scales among three arms (p > 0.05). 97%, 94%, 88% of overall response rates noted in CCRT, PCRT and PCHEMO arm patients respectively. But 55% and 24% of PCRT and PCHEMO arm patients had pathological complete responses with the significance of p = 0.0016. CCRT arm patients had a larger amount of symptom expertise, difficulties in sexual functioning and sexual agony
Conclusion: We observed equivalent therapeutic response, better toxicity profile and better quality of life among the patients treated with PCRT arm than the standard CCRT arm patients.
Clinical significance: This approach could be feasible in developing countries wherein brachytherapy resources are scarce.
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