Preethi, A (2017) Role of Concurrent Chemoradiation with Weekly Cisplatin and Paclitaxel followed by HDR Intracavitary Brachytherapy in Locally Advanced Carcinoma Cervix. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION: Carcinoma cervix is the most common gynaecological malignancy in women. Concurrent chemoradiotherapy is an effective treatment program for locoregionally advanced squamous cell carcinoma of the cervix, with established benefits in both organ preservation and survival. AIM OF THE STUDY: 1. To assess the immediate locoregional response rates of locally advanced squamous cell carcinomas of the cervix treated with concurrent chemoradiotherapy using weekly low dose cisplatin and low dose paclitaxel followed by HDR intracavitary brachytherapy. 2. To assess the acute toxicity during treatment. MATERIALS AND METHODS: This is a single arm prospective study in which 30 patients with cervical carcinoma of stages IB2-IIIB, presenting in Department of Radiotherapy, MMC & RGGGH, were given concurrent chemoradiation-50Gy (200cGy/# in 25#) with weekly Inj.Cisplatin 30mg/m2 and Inj.Paclitaxel 30mg/m2 followed by intracavitary brachytherapy (8Gy in 2#). The response, both clinical and radiological, was assessed 6 weeks after completion of therapy, using RECIST criteria. Toxicity was assessed using RTOG Morbidity scoring. RESULTS: Clinically, there was complete locoregional response in 27 patients (90%), partial response in 3 patients (10%). Complete response was seen in 92.8%(13/14) and 84.6%(11/13) of stage IIB and IIIB respectively. Acute toxicities were observed but they were manageable. Diarrhea presented as grade I and II in 15 (50%) and 3 (10%) patients respectively. Grade I haematological toxicity was seen in 7 patients (23.3%) and grade II in 3 patients (10%) during the 5th week of chemo-radiation. Grade I and II skin reactions were seen in 17 patients (56.7%) with grade III reactions seen in one patient. CONCLUSION: Thus, this study shows that including a taxane as a radiosensitiser, in the standard concurrent chemoradiation with weekly cisplatin schedule, has shown better loco-regional response with acceptable toxicity, especially in locally advanced stages and those with pelvic nodal involvement (IIIB).
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.201419003 |
| Uncontrolled Keywords: | Carcinoma cervix, Cisplatin, Paclitaxel, Chemoradiation, Brachytherapy. |
| Subjects: | MEDICAL > Radio Therapy |
| Depositing User: | Subramani R |
| Date Deposited: | 20 Jul 2020 16:34 |
| Last Modified: | 20 Jul 2020 16:34 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12584 |
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