A Prospective Randomized Study Comparing Accelerated Radiotherapy Versus Conventional Concomitant Chemoradiation in Locally Advanced Carcinoma Cervix

Introduction: In locally advanced carcinoma cervix (FIGO stage IB3-IVA) chemoradiation is the standard of care. But weekly concurrent chemotherapy can be poorly tolerated for elderly patients or patients with certain comorbidities. In this study efficacy and safety of accelerated radiotherapy is compared with definitive chemoradiation. Methodology: Total 67 patients were enrolled, 32 patients had received accelerated radiotherapy alone and 35 patients had received chemoradiation, dose of radiation was 50Gy/25# in both arms. All the patients received HDR brachytherapy of dose 7Gy×3# to point A. Objectives: Locoregional tumour control was the primary endpoint. Toxicity profile, Overall treatment time (OTT), Disease free survival (DFS) and Overall survival (OS) were the secondary endpoints. Unpaired t-test and chi square test were used for continuous and categorical variables. Result: Tumour response was comparable in both arms. The median OTT was 54 days in accelerated radiotherapy arm which is significantly lesser compared to 62 days in chemoradiation arm (p-value <0.0001). Acute and late toxicities, DFS and OS were also comparable in both arms. Conclusion: Accelerated radiotherapy is a feasible and safe treatment option for locally advanced carcinoma cervix with added benefit of lesser treatment time. Keywords: Overall treatment time (OTT), Accelerated fractionation (AF), Tumour response.