Evaluation of Clinical Response and Toxicities of Concurrent Weekly Cisplatin in Comparison to Weekly Paclitaxel with External Beam Radiotherapy in the Treatment of Locally Advanced Cervical Cancer (IIB-IVA)

Abstract

This quasi-experimental study was performed in the Department of Radiotherapy of Dhaka Medical College Hospital, Dhaka for one year period from July 2019 to June 2020. The aim of the study was to evaluate and compare tumor response and toxicities of weekly cisplatin and paclitaxel along with External Beam Radiotherapy in the treatment of locally advanced cervical cancer. Sixty previously untreated female patients with histologically proven locally advanced squamous cell carcinoma of cervix (stage IIB-IVA) were randomized into concurrent chemoradiation with weekly cisplatin and weekly paclitaxel group with thirty patients falling in each group. They were followed up for 3 months at the OPD. Treatment response and toxicities were assessed and compared between two groups. Majority of the patients in both groups were less than 50 years of age. The mean number of chemotherapy cycles was comparable with 90% and 80% of patients receiving 5 doses in arm A & B respectively. Nausea & vomiting were higher in cisplatin group. Diarrhea, allergic reaction, peripheral neuropathy & neutropenia were more in paclitaxel group. There was a complete response rate of 63.3% in cisplatin group and 56.7% paclitaxel group. There were only 3 patients who discontinued treatment (1 in cisplatin group & 2 in paclitaxel group) due to drug-related toxicities. This small prospective study shows that weekly paclitaxel was as effective as weekly cisplatin in concurrent chemoradiation for locally advanced carcinoma of cervix. So, paclitaxel can be used as an alternative to cisplatin in cisplatin contraindicated cases.