Chemotherapy and Management of Locally Advanced Carcinoma Cervix

Background & Objective: the present study was undertaken to ascertain the incidence of early, advanced cancer cervix and its recurrence and role of chemotherapy in locally advanced cancer cervix. Material and Methods: The present study was conducted in the Departments of Obstetrics & Gynaecology, Pathology and Radiotherapy and the specimens examined in the Department of Pathology of Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India from July 2009 to July 2010. One hundred histologically confirmed carcinoma cervix cases were divided into two groups. I: Study group of cases receiving different types of chemotherapy and II: Control group comprised of cases on pre and postoperative radiotherapy and surgery. Patients were staged and locally advanced inoperable cases (Stage IB-IVA) were given different types of chemotherapy. Thereafter subjective and objective assessment was made according to World Health Organization (WHO) criteria of tumor response. Results: Majority of cases (60.0%) presented in stage IIB of disease by International Federation of Gynecology and Obstetrics (FIGO) classification. Commonest symptom was postmenopausal vaginal bleeding, 70.0% cases. 68.0% & 56.0% cases showed complete response (CR) on chemotherapy and radiotherapy respectively. Stage IIB patients showed the best response with CR in 70.0% & partial response (PR) in 16.7% cases. Colposcopic evaluation on 12 -18 months follow up showed 08 to be disease free, with decrease in size of tumor. Conclusion: Chemotherapy is an effective mode of therapy and can be considered as an adjunct to surgery or radiotherapy to improve the overall survival of cancer cervix patients.