A Prospective Interventional Study Comparing Weekly Cisplatin With Weekly Cisplatin and Paclitaxel in Chemoradiation of Carcinoma Cervix

Background: Cervical cancer remains a major health burden in developing countries. Cisplatin-based chemoradiation is the standard of care for locally advanced cervical cancer. However, recurrence and treatment failure remain significant. Paclitaxel, a radiosensitizer, has shown promise when combined with cisplatin. To compare the clinical outcomes and treatment-related toxicities of weekly cisplatin alone versus weekly cisplatin with paclitaxel during concurrent chemoradiation in carcinoma cervix. Materials And Methods: This prospective randomized interventional study included 90 patients with histologically confirmed carcinoma cervix (FIGO stage IIA2–IIIC). Patients were randomized into two groups: Arm A (cisplatin 30mg/m2 + paclitaxel 40mg/m2) and Arm B (cisplatin alone 30mg/m2). Both groups received IMRT (50gy in 25 fractions) followed by HDR brachytherapy (21gy in 3fractions). Acute toxicities were assessed weekly; response was evaluated at completion of treatment and at 3 and 6 months using RECISTcriteria. Results: Complete response rates at 6 months were 95% in the cisplatin + paclitaxel group and 93% in the cisplatin group (p = 0.5). The cisplatin + paclitaxel arm had significantly higher rates of Grade II diarrhoea, nausea and vomiting, and proctitis (p < 0.05). Hematologic and nephrotoxic profiles were comparable. Conclusion: Adding paclitaxel to weekly cisplatin during chemoradiation for carcinoma cervix improves complete response rates numerically but increases acute toxicity significantly. Further studies are warranted to balance efficacy and tolerability