Carcinoma Cervix-A Prospective Randomised Study

The aim of this study was to determine whether the addition of concurrent cisplalin and hyperfractionation in external pelvic radiotherapy improves local control and survival in paticnts with locally advanced carcinoma cervix as compared to treatment with conventional radiolherap.J alonc. The morbidity oftwo treatment protocols was also compared. Sixty patients of ne" I) diagnosed squamous cell carcinoma cervix, FIGO stage 118 and III were randomised into the following two treatment protocols: Group A (study group): Cisplatin30 mg/m2 "eekly x 5 courses and e"lernal beam pelvic radiotherapy 50 Gy/33#4.5 weeks with hyperfractionation in first and f01ll1h weel,s. Group B (control group) : External beam pelvic radiotherapy 46 Gy/23#/4.5 weeks. Patients in both the groups\vere then treated with intracavitary brachytherapy by LDR/MDR Selectron and a dose of28 Gy was delivered to point A. The patienls who were not suitable for intracavitary trcatmell1 were treated by supplementary external beam pelvic radiotherapy 20 Gy/ 10#/2" ceks. The actuarial local control at 4 years was 60% in group A and 42% in Group 8 9p<0.05). The aCluarial disease free survival at 4 years was 52% in Group A and 35% in Group 8 (p<0.05). Only gl'ade I acute and delayed haematological toxicity and grade I nausea and vomiting as acute toxicity "ere significantl) higher for Group A patients as compared to Group 8. Concomitant chemotherapy with hyperfraclionated radiotherapy is well tolerated and seems to offer potential benefit for imprOl ing the locoregional control in locally advanced carcinoma of cervix.