Comparison of Efficacy between Hypofractionated and Conventional Fractionated Chemoradiotherapy in the Management of Locally Advanced Carcinoma Cervix

Abstract

Introduction: Cervical cancer is the 4^th most common cancer among women in the world. Surgery, radiotherapy, or chemotherapy are the main treatment options for cervical cancer either alone or in combination.

Methods and materials: This quasi-experimental study was conducted at the Department of Radiation Oncology, National Institute of Cancer Research and Hospital (NICRH), Dhaka, from November 2020 to October 2021.  A total of 60 patients were selected as study subjects as per inclusion and exclusion criteria. Data were analyzed by SPSS version 25.0.

Result: On per vaginal examination growth was present in 20.00% of patients, fornix obliterated in 10.00% and parametrium involved 6.67% of patients in arm A, the number is 16.67%, 13.33%, 10.00% for arm B patients on 3^rd follow-up.  Growth was assessed using MRI after 12 weeks of RT completion. In arm A, 21 patients and in arm B, 23 patients showed absence of growth. Almost equal numbers of patients in both arms experienced a complete response (21 in arm A and 23 in arm B). Partial responses were in nine patients in arm A and seven patients in arm B. This difference in outcome was not statistically significant (p >0.05).

Conclusion: The study found that hypofractionated radiotherapy (37.5 Gy in 15 fractions) with concurrent weekly cisplatin is as effective as conventional radiotherapy (50 Gy in 25 fractions) with cisplatin for locoregional control in inoperable locally advanced cervical cancer.