RESULTS OF ADJUVANT PACLITAXEL AND CARBOPLATIN AFTER CONCURRENT CHEMO RADIATION (CCRT) IN LOCALLY ADVANCED CERVICAL CANCER (LACC)

Background: Concurrent chemo radiation (CCRT) is the standard treatment for locally advanced cervical cancer (LACC) FIGO stage IIB-IVA.However, failure rate after treatment is still as high as 30% to 40% of which local and distant failures are 17% and 18% respectively and the 5-year survival is still poor.Aim of incorporating adjuvant chemotherapy (ACT) is to target the residual disease in the pelvis and to treat occult disease outside the pelvis. Objective: This study aims to evaluate the feasibility and benefit of adjuvant chemotherapy (ACT) after CCRT in such patients to the improve treatment outcome. Material and Methods: From July 2017-June 2018, eighty patients of LACC were prospectively evaluated. All patients received radiation upto 50Gy with Cisplatin 40 mg/ m2 followed by intra-cavitary radiotherapy- 3fractions of 7 Gy each (28 Gy equivalent). Adjuvant chemotherapy with Paclitaxel (175 mg/m2) +Carboplatin (AUC 5) was planned for all patients to a median of four cycles (range 3?6 cycles). Results: Eighty evaluable patients were enrolled for adjuvant chemotherapy. Disease-free survival after a median follow-up of 14 months (range 8-20) was 83.75% showing a significantly long term tumor control. The adjuvant chemotherapy was well tolerated. Hematologic and neurologic toxicities were most common side effects in our study however, they were manageable. Conclusion: Incorporating adjuvant chemotherapy with Paclitaxel and Carboplatin after concomitant chemoradiation is effective, safe and may be a very promising treatment protocol for advanced cervical cancer.