Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study

Purpose: To assess chemoradiation related acute morbidity in women with carcinoma cervix and to findand correlation between hematologic toxicity and organ system specific damage. Materials and
Methods: Aprospective study was carried out between August 2012 and July 2013 enrolling 79 women with cancer cervixreceiving chemo-radiotherapy. Weekly assessment of acute morbidity was done using the National CancerInstitute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4 and the toxicities weregraded.
Results: Anemia [77 (97.5%)], vomiting [75 (94.8%)] and diarrhea [72 (91.1%)], leukopenia [11(13.9%)], cystitis [28 (35.4%], dermatitis [19 (24.1%)] and fatigue [29 (36.71%)] were the acute toxicities noted.The toxicities were most severe in 3rd and 5th week. All women could complete radiotherapy except two due tocauses unrelated to radiation morbidity; seven (8.86%) had to discontinue chemotherapy due to leukopenia andintractable diarrhea. Though there was no correlation between anemia and other toxicities, it was found that allwith leukopenia had diarrhea.
Conclusions: Chemoradiation for cancer cervix is on the whole well tolerated.Leukopenia and severe diarrhea were the acute toxicities that compelled discontinuation of chemotherapy intwo women. Though anemia had no correlation with gastrointestinal toxicity, all of those with leukopenia haddiarrhea.