J Integr Oncol, an open access journal ISSN: 2329-6771 Volume 8 • Issue 1 • 1000220 Open Access J o u r n a l o f I n t e g r a t i v e O n c o l o g y ISSN: 2329-6771 Journal of Integrative Oncology Research Article Open Access Dubey et al., J Integr Oncol 2019, 8:1 Keywords: Carcinoma cervix; Docetaxel; Chemoradiation; HDR brachytherapy Abbreviations: KPS: Karnofsky Performance Scale; EBRT: External Beam Radiotherapy; ICBT: Intracavitary Brachytherapy; CR: Complete Response; PR: Partial Response Introduction Cervical cancer is the most common gynecologic malignancy. It is the fourth most common malignancy in females in both incidence and mortality, worldwide. It is being estimated that around 7.9% (527,600) new cases of cervical cancer are there worldwide and it leads to approximately 7.5% (265,700) deaths in a year [1]. Cervix cancer is more common in economically disadvantaged people and constitutes about 85% of new cases diagnosed. In India, Cervical cancer is the second most common cancer in females afer breast cancer, which leads to around one lac of new cases every year [2]. In various cancer registries, the age- adjusted incidence rate varies from 4.9 to 30.2 per 100,000 women in India [3]. A most common histopathological subtype of cervical cancer is squamous cell carcinoma which accounts for around 90% cases. Histopathological grading is done as well diferentiated, moderately diferentiated and poorly diferentiated cancer [4]. A combined modality approach is necessary for the management of patients with cervical cancer. For locoregionally advanced disease (stage IIB, III, IVA) concomitant chemoradiation is the primary treatment modality. Currently, the two main modalities of irradiation are external photon beam and brachytherapy. At the completion of treatment, the central tumor should receive approximately 8000-8500 cGy. In bulky tumors, the total dose may reach 9500 cGy [5]. Radical radiotherapy fails to control 35%-85% of patients with locally advanced cervical cancer. Simultaneous chemoradiation has demonstrated to be superior to radiotherapy alone. Some randomized trials have shown that the use of concomitant chemotherapy has resulted in 30%-50% decrease in the risk of death as compared to RT alone [6]. A recent meta-analysis reported that chemoradiotherapy leads to a 6% improvement in 5-year survival when compared with radiotherapy alone [7]. Cisplatin is one of the most potent antitumor agents known, displaying clinical activity against a wide variety of solid tumors. However, despite the use of concurrent chemoradiation with cisplatin in locally advanced carcinoma cervix, many patients have experienced locoregional failure (20%-25%) and distant failure (10%-20%). Te Cochrane meta-analysis has shown that the advantage of concomitant chemoradiation decreases as the stage increases. Tese facts have stimulated an interest in exploring other concurrent combinations with potentially more clinical efect [5,8,9]. Tus, though a number of chemotherapeutic drugs have been used for concomitant chemoradiation, concomitant cisplatin and docetaxel have shown improved progression-free survival and disease-free survival with acceptable side efects. Keeping these things in mind we administered concomitant cisplatin and docetaxel in our study group in a hope to improve local control by addressing the hypoxic population of tumor cells and also to keep the side efects to a tolerable level. *Corresponding author: Manas Dubey, Department of Radiation Oncology, Regional Cancer Centre, Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India, E-mail: drmanas001@gmail.com Received December 24, 2018; Accepted January 16, 2019; Published January 23, 2019 Citation: Dubey M, Singh B, Kaushal V, Dhankhar R, Atri R, et al. (2019) To Compare Tumor Control, Side Effects and Treatment-Related Toxicity of Two Concomitant Chemoradiation Schedules in Carcinoma of Cervix. J Integr Oncol 8: 220. Copyright: © 2019 Dubey M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Currently, the standard treatment for locally advanced cervical cancer patients is concurrent chemoradiotherapy. A number of chemotherapeutic drugs have been used in a concomitant setting along with radiotherapy in the management of cervical cancer. Docetaxel and cisplatin have shown improved overall response rates with acceptable side effects. Here we aim to compare tumor control, side effects and treatment-related toxicity in two concomitant chemoradiation schedules. Methods: The patients were divided randomly into two groups of thirty patients each. Both the groups were treated with a combination of External Beam Radiotherapy (EBRT) with 50 Gy/5 weeks/25 fractions to the whole pelvis along with concomitant chemotherapy. Group I (study group) received concomitant chemotherapy with injection docetaxel (20 mg/m 2 ) and injection cisplatin (50 mg/m 2 ) intravenously weekly for 5 weeks followed by HDR brachytherapy. Group II (Control Group) patients received concurrent cisplatin 40 mg/m 2 intravenously weekly for fve weeks followed by HDR brachytherapy. Results and Conclusion: The survival difference in the two groups was not statistically signifcant (p-value=0.718). Acute hematological and lower gastrointestinal toxicities were higher in the study group than the control group but these were not statistically signifcant. There was a trend towards better local control and better disease-free survival with doublet chemotherapy (docetaxel plus cisplatin) as compared to a single agent (cisplatin), but it was not statistically signifcant. To Compare Tumor Control, Side Effects and Treatment-Related Toxicity of Two Concomitant Chemoradiation Schedules in Carcinoma of Cervix Manas Dubey * , Baljit Singh, Vivek Kaushal, Rakesh Dhankhar, Rajeev Atri, Anil k Dhull and Faraz Khan Department of Radiation Oncology, Regional Cancer Centre, Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India