Outcome of Treatment and Causes of Failure in Cancer Cervix Treated with Concurrent Chemoradiation

Abstract

Introduction: Cervix uteri cancer is most known disease
found among women worldwide after breast, colorectal and
lung cancers. The present study aimed to evaluate prognostic
factors (patient, tumor and treatment) in carcinoma of cervix
treated with concurrent chemoradiation.
Materials and Methods: A total of 40 patients included in the
study and were planned to deliver by 3-Dimensional Conformal
(DC) radiotherapy using four field box technique.Radiotherapy
dose delivered to pelvic area was 50 Gy in 25 fractions at
200cGy/dayfollowed by intracavitary brachytherapy either 4
applications of 6 Gy/fraction or three applications of 7 Gy/
fraction each as per departmental protocol. Chemotherapy
dose delivered to patients received cisplatin 35mg/m2 weekly
i.v. for a total of 5 cycles or 75mg/m2 triweekly i.v. for a total of
2 cycles. All patients were followed up at least 6 months from
day of completion of treatment.
Result:Collected data was analyzed using Chi Square test
to calculate level of significance it was found that significant
prognostic factors are blood haemoglobin level (p = 0.006),
stage (p = 0.016), histological grade (p = 0.039), lymph node
involvement (p = 0.031), parametrial extension (p = 0.038),
hydronephrosis (p = 0.015), tumor size (p = 0.038) and
duration of treatment (p = 0.031) whereas age, histological
type and subtype, total radiation dose and concurrent use of
chemotherapy are found to be insignificant.
Conclusion: The outcomes of cancer cervix patent depends
upon patient, tumor and treatment related factors. Presence of
poor prognostic factors related to tumor may need intensification
of the treatment by concurrent use of chemotherapy drugs,
counteracting hypoxia by maintaining hemoglobin during
treatment.