Cisplatin versus gemcitabine as concurrent chemoradiotherapy in squamous cell carcinoma cervix: A comparative study of clinical response and toxicities

Cervical cancer ranks as the four leading cause of cancer death in women worldwide. It is the third most common cancer in India. Most patients present in advanced stages. Concurrent chemoradiation is the standard of treatment for locally advanced cervical cancer. Aims: The aim of the study was to compare the treatment response and hematological, gastrointestinal, and skin toxicity of cisplatin versus gemcitabine as concurrent chemoradiotherapy. Materials and Methods: This study was conducted from February 2017 to August 2018. Sixty patients of squamous cell carcinoma cervix with Stage IIB to IIIB were randomly allocated to either weekly gemcitabine (observation arm) 150 mg/m(2) or cisplatin (control arm) in the dose of 35 mg/m(2) along with concurrent radiotherapy. Treatment response and toxicities of both drugs were evaluated. Results: Gemcitabine arm has more Grade 2 (23.3% vs. 10%) and Grade 3 (3.3% vs. none) hematological toxicity as compared to cisplatin arm. For gastrointestinal toxicity, Grade 2 toxicity was observed more in cisplatin arm (23.3%) as compared to 13.3% in gemcitabine arm. Skin toxicity was found to be insignificant. There was complete response of 86.7% in cisplatin arm, while 73.3% in gemcitabine arm. Conclusion: Cisplatin has a better treatment response as compared to gemcitabine as concomitant chemotherapy agent with external beam radiation therapy. Hematological toxicity was more in gemcitabine arm and gastrointestinal toxicity was more in cisplatin arm. The skin toxicities were comparable in both the arms.