Publication:

Comparison of outcomes and toxicities of concurrent chemo-radiation with weekly cisplatin versus weekly paclitaxel in locally advanced cervical carcinoma

Background Cervical cancer remains a leading cause of cancer-related death among women. Concurrent chemoradiation with Cisplatin is the standard treatment for locally advanced disease, though outcomes remain suboptimal. Alternative non-platinum agents like Paclitaxel have been explored to improve efficacy and tolerability.

Methods This quasi-experimental study was conducted at the Department of Radiotherapy, Rajshahi Medical College Hospital, from January 2022 to June 2023. Seventy patients with locally advanced squamous cell cervical cancer were equally assigned into two groups by purposive sampling. Arm A received weekly cisplatin (40 mg/m²) and Arm B received weekly paclitaxel (50 mg/m²), both with external beam radiotherapy followed by HDR brachytherapy. Patients were evaluated at weeks 4, 8, and 12 post-treatments. Data were analyzed using SPSS version 25.

Results Of 70 patients, 68 completed treatment. Mean age was 48.46±8.80 years. Most patients were stage IIB (60.3%) and moderately differentiated (63.2%). Complete response was observed in 82.4% (Arm A) and 73.5% (Arm B), while partial response occurred in 14.7% and 20.6%, respectively (p>0.05). Hematologic toxicity and gastrointestinal side effects were higher in Arm B, whereas nausea, vomiting, and renal toxicity were more frequent in Arm A; differences were not statistically significant.

Conclusions Weekly paclitaxel is not inferior to cisplatin in treatment response and may serve as an alternative when cisplatin is contraindicated, considering toxicity and cost.