CONVENTIONAL VERSUS THREE-DIMENSIONAL CONFORMAL EXTERNAL RADIOTHERAPY IN CANCER CERVIX: A COMPARATIVE STUDY FOR COMPLIANCE, RESPONSE AND TOXICITY

Abstract

Introduction: Cervical cancer is the second most frequent cancer among Indian women.
Radiotherapy is the cornerstone of treatment in all its stages. Three-dimensional conformal
radiotherapy (3DCRT) combines multiple radiation fields to deliver precise dose of radiation
to the affected area. Tailoring each of the radiation fields to focus on the tumor delivers a high
dose of radiation to the tumor and avoids nearby healthy tissue. The present study is done to
compare conventional radiotherapy versus 3DCRT in cancer cervix for compliance, clinical
response and toxicity.
Material and Methods: Fifty patients were enrolled and randomised into two radiotherapy
plans with radical intent - Group A treated by conventional radiotherapy and group B treated by
3DCRT. Concurrent cisplatin was delivered on weekly (35mg/m2) or tri-weekly (75mg/m2)
basis during external beam Radiotherapy and was followed by High Dose Radiotherapy
Brachytherapy. Clinical response and complication assessment were evaluated.Collected data
was analyzed using standard statistical methods and softwares to calculate level of
significance using “p” value by chi square test.
Results: In this study mean age of the patients was 48 years (26-67 years). The anemia was the
most common side effect seen in both groups (96% vs 88%, p=0.29). Neutropenia was more in
group B (36% vs 44%, p= 0.56). Lower GI toxicity was seen only in patients in group A (20%
vs 0%, p=0.018). In follow up there were no significant early rectal and bladder reactions in
both groups and 2 patients in each group had late rectal reactions of grade I and II (p= 0.312).
No significant skin, bladder and small intestinal toxicity were seen in both groups.
Conclusions: Conventional radiotherapy gives equally efficacious response though
accompanied by toxicities which were acceptable.