Toxicity Profile in Cervical Cancer Patients Receiving Chemoradiation with Concurrent Parametrial Boost

Abstract

Introduction Radical surgery or chemoradiation therapy is the options for treating early stage cervical cancer. The advanced stages are treated with radiation alone or concurrent chemoradiation. Concurrent cisplatinum based chemoradiation is considered the standard of care for carcinoma of the cervix and has shown a significantly improved overall survival and progression free survival in locally advanced cancers.  Despite improved survival one third of the patients with advanced cancer of cervix have failure within two years. So continued improvement in treatment of advanced cervical cancer is needed. The concurrent parametrial boost with chemoradiation helps in loco regional control. Objective: To determine toxicity profile in patients with cancer of cervix receiving chemo radiation with concurrent parametrial boost. Study Design: It is descriptive case seriesSetting and duration: Radiotherapy Department Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore from December 2008 to June 2009. Material and methods: Forty patients with locally advanced carcinoma of cervix were included. Concurrent parametrial boost was given along with chemoradiation. Patients were evaluated for toxicity weekly during treatment. SPSS software was used for data analysis. Results: 40 patients with stage II-B to IV-A of carcinoma cervix were studied. 22.5 % patients suffered from Grade 1-3 diarrhea, 27.5% had Anemia, 40 % developed neutropenia and 17.5 % suffered thrombocytopenia. Conclusion: Concurrent parametrial boost in locally advanced cervix carcinoma offers good results in terms of acceptable toxicity.