Comparison of outcomes and safety of concurrent chemoradiotherapy with weekly cisplatin and paclitaxel verses cisplatin alone in locally advanced cervical cancer.

Abstract

Objective: To evaluate the outcome, survival and safety of weekly combination therapy with cisplatin and paclitaxel chemoradiotherapy in comparison with cisplatin alone in locally advanced cervical cancer. Study Design: Prospective study. Setting: Oncology Department of Nishtar Hospital, Multan. Period: May 2024 to May 2025. Methods: A total of 100 women with locally advanced epithelial cell cervical carcinoma, KPS score of ≥70 and normal bilirubin, urea, creatinine and nitrogen were selected. Patients were divided into control group and study group consisting of 50 patients each. Control group was administered 40 mg/m2 of IV cisplatin once a week with a maximum weekly dose of 70 mg. Study group was administered 50 mg/m2 paclitaxel and 30 mg/m2 cisplatin once a week. External beam radiotherapy was performed in all patients at the same time of chemotherapy targeting cancer site, internal and upper external iliac, uterus, presacral and common iliac lymph nodes. Results: At the last follow-up, 80% patients in control group and 88% in study group survived. 17 patients (34%) in control group and 10 (20%) in study group had a recurrence so the disease-free survival was 66% and 80%, respectively. 12 patients (24%) in control group had local recurrence and 5 (10%) had distant recurrence. 5 patients (10%) in study group had local recurrence and only one (2%) had distant recurrence. No treatment related deaths occurred but 14 patients (28%) in control group and 27 patients (54%) suffered grade 3 or 4 toxicities, the difference was significant (p=0.02). Significantly higher number of patients in study group had gastrointestinal toxicities than control group. Conclusion: Concurrent cisplatin and paclitaxel chemoradiotherapy had better outcomes with increased but manageable toxicities than cisplatin chemoradiotherapy alone.