Is neo‑adjuvant chemotherapy a better option for management of cervical cancer patients of rural India.
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Date
2016-01
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Abstract
OBJECTIVES: To explore alternate modality of treatment in patients of advanced cancer cervix by neo‑adjuvant chemotherapy (NACT) followed
by External Beam Radiotherapy (ERT) and Brachytherapy (BT). Short‑ (6 months) and long‑ (12 months) term follow‑up data from these patients
were compared with the retrospective data from an urban cancer centre, where standard protocol of concurrent chemo‑radiotherapy is practiced.
MATERIALS AND METHODS: Two hundred patients of advanced cervical cancer, treated at our rural cancer centre between January 2007 and
December 2007, were included in the study arm (Group A). These patients received three cycles of neo‑adjuvant chemotherapy with Cisplatin,
Bleomycin, and Vincristine before External‑Beam Radiotherapy (EBT) followed by brachytherapy. Patients in the control arm (Group B) of an urban
cancer centre, received EBT with weekly concomitant Cisplatin, followed by brachytherapy. Short‑ (6 months) and long‑ (12 months) term follow‑up
data from our patients were compared with the retrospective data from the urban cancer centre. RESULTS AND ANALYSIS: Complete response
rate was comparatively higher among patients of Group A, also correspondingly proportion of patients showing progressive disease and stable
disease was lower among them. Local treatment failure was 87.5% among patients from Group A and 94.4% in Group B patients. Concomitant
chemoradiation (CRT) was associated with more GI toxicities. CONCLUSION: Our result suggests NACT arm is as effective as CRT arm in respect
of complete response with less pelvic failure and G.I toxicities. Further follow‑up data are needed before arriving at a definite conclusion.
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Keywords
Cancer cervix, chemo‑radiation, concomitant, neo‑adjuvant
Citation
Dastidar G A, Gupta P, Basu B, Basu A, Shah J K, Seal S L. Is neo‑adjuvant chemotherapy a better option for management of cervical cancer patients of rural India. Indian Journal of Cancer. 2016 Jan-Mar; 53(1): 56-59.