SIGNS, SYMPTOMS CHANGES AND SUCH-P/V DISCHARGE, P/V BLEEDING, PELVIC PAIN, FEVER WITH CHEMO-RADIOTHERAPY AND RADIOTHERAPY IN THE TREATMENT OF CERVICAL CANCER

H. N. Ashikur Rahaman* and Shravana Kumar Chinnikatti

ABSTRACT

Introduction: Cervical cancer is the fourth most frequent cancer in women with an estimated 570,000 new cases in 2018 representing 6.6% of all female cancers. Approximately 90% of deaths from cervical cancer occurred in low- and middle-income countries. The high mortality rate from cervical cancer globally could be reduced through a comprehensive approach that includes prevention, early diagnosis, effective screening and treatment programmes. Objective: To find out Signs, Symptoms changes and such -P/V discharge, P/V bleeding, pelvic pain, Fever with Chemo-Radiotherapy and Radiotherapy in the Treatment of Cervical Cancer. Methods and Materials: The study had conducted in the Department of Radiation Oncology, Enam Medical College Hospital, Savar, Dhaka & in the department of Radiation Oncology, National Institute of Cancer Research & Hospital (NICRH), Dhaka from July 2018 to June 2019. Experimental study- Randomized Control Clinical Trail. Patients with carcinoma cervix attained at the Radiation Oncology Department of EMCH & NICRH during the study period had included in the study according to inclusion an exclusion criterion. Patients- Clinically diagnosed and histologically proved squamous cell cervical carcinoma. Results: A total of 80 patients (40 patients in side A & 40 patients in side B) who have biopsy proven cervical carcinoma with no history of previous treatment were selected from the Department of radiotherapy Enam Medical College Hospital, Savar, Dhaka and in the department of Radiation Oncology, National Institute of Cancer Research & Hospital. All patients in both side received external beam radiation with 50Gy in 25 daily fractions over five weeks. Distribution of study population according to presence of symptoms. Bar chart showed distribution of study population according to presence of symptoms. Almost all the study population had presented with P/V watery discharge with pelvic pain. Majority of the patient presented with P/V bleeding, fever and anorexia. A significant symptomatic improvement was found in side-A, after treatment than side-B. Mildly increases in 2nd week of treatment then decline gradually. Overall treatment related toxicity was more in side-A than side-B. In Grade-I nausea/vomiting and skin reaction in Grade-II were more in side-A. Leukopenia and anaemia II also more in side-A Grade-I and II respectively. Data was analyzed by using chi-square test and result was not significant in nausea/vomiting and skin reaction and significant in leukopenia at p<0.05. Conclusion: In this study it was observed that patients of carcinoma cervix treated with concurrent chemo radiotherapy was effective for symptomatic improvement and suitable with acceptable toxicity for advanced cancer of the uterine cervix than those with radiation only.

Keywords: cervical cancer, radiation therapy, chemoradiation treatment, randomized trials.