Sensitising Cervix Against Cancer : Addition of gemcitabine to standard therapy in locally advanced cervical cancer: A randomized comparative study

The concurrent Chemoradiotherapy for cervical cancer treatment is well accepted since 1999. This study was aimed to observe if any improved outcome could be obtained capitalizing on the synergistic activity of Gemcitabine, Cisplatin, XRT. Stage IIB-IIIB were randomized to control group and study group. Control group received Cisplatin 40 mg/m2 weekly with concurrent XRT, followed by brachytherapy and study group received Gemcitabine 125 mg/m2 weekly top of the same control group treatment. The primary end-point was pathological response and toxicities along with patient compliance to treatment, late reactions, DFS & OS in a scenario like our local community. The complete response was slightly better in study arm. Toxicities were significantly high in the study group compared to control group. The distant failure prevailed in control arm. On a median follow up of little less than two years, the DFS in study arm was slightly better than control arm. If the toxicity can be managed adequately in the combination chemo radiation group, it may produce an improvement in response. Survival benefit can also be obtained by introducing gemcitabine to cisplatin as radio sensitizer.