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Background Despite the current standard of concurrent chemoradiation (CCRT), around 30–40% are still dying from locally advanced cervical cancer. Increasing the radiation dose further was not a feasible option, but addition of chemotherapy further was tried due to the different toxicity profiles of it. So, the use of consolidation chemotherapy beyond CCRT has been studied. Aim To evaluate the efficacy, toxicity, tumour response and loco-regional control following consolidation chemotherapy after concurrent chemoradiation in locally advanced carcinoma cervix (LACC). Methods The patients were randomized into two arms: the conventional arm (control arm, n = 30) patients received conventional treatment with weekly injection cisplatin (35 mg/m 2 ) concurrently with pelvic external beam radiation (50 Gy/25 fraction, 2 Gy/fraction, 5 fraction weekly) followed by intracavitary radiotherapy of 21 Gy in 3 fractions of 7 Gy each by HDR brachytherapy. In the interventional arm (study arm, n = 30), patients received the standard treatment followed by 3 cycles of consolidation chemotherapy (paclitaxel + carboplatin) every three weekly. Results Haematological toxicity (grade 3 anaemia and grade 1 leucopenia, grade 1 and 2 thrombocytopenia) was higher in the study group. Renal, hepatic and gastrointestinal toxicity was more in the study arm. Peripheral neuropathy was mostly seen in the study arm. Median follow-up was 9 months. Treatment response was better, and the rate of recurrence was less in the study arm. Conclusion Addition of few cycles of consolidation chemotherapy after standard treatment is beneficial in patients with LACC with manageable toxicity and good compliance.

Purpose- To evaluate and compare the safety and efficacy of 60 Gy versus 50 Gy dose radiotherapy with concurrent chemotherapy in locally advanced unresectable oesophageal cancer. Methods- Study design was prospective, randomized and comparative. 60 Patients (30 patients in each arm) with histologically proven locally advanced unresectable oesophageal carcinoma and with good balance in observed co-variables were enrolled. Total radiation dose of 60 Gy was given in one arm while 50 Gy in another arm. Weekly CCRT was given till radiotherapy treatment completion in both the arms with paclitaxel 75 mg/m2 and carboplatin AUC 2. Statistical analysis was done using SPSS version 2.0. At 4 weeks of completion of treatment and after 6 months follow-up, response was assessed using RECIST (1.1) criteria. Results- In 60 Gy dose arm, 76.66% patients and in 50 Gy arm, 70% patients achieved CR but the difference was statistically non- significant (p= 0.559). After 6 months of median follow up, 60% patients in 60 Gy arm and 50% in 50 Gy arm had CR whereas 30% patients in 60 Gy arm and 40% in 50 Gy arm had LRF. There were no statistically significant differences between the two arms in leucopenia (p=0.576), nephrotoxicity (p=1.0), radiation dermatitis (p=0.615), vomiting (p=0.921) and diarrhoea (p=1.0). Conclusion- 60 Gy dose radiotherapy with concurrent chemotherapy can be used feasibly and safely with only a few manageable side effects and with favourable benefit-risk profile, especially in terms of local tumour control. However, to validate this conclusion, large sample size and longer follow-up will be required.

OBJECTIVESA prospective study to compare weekly cisplatin versus weekly paclitaxel as concurrent chemotherapy with standard radiotherapy in locally advanced carcinoma cervix. METHODSThe study was carried out between November 2013 and August 2104; 60 newly diagnosed women with histopathologically proven squamous cell carcinoma cervix (FIGO stage IB2 to IVA were enrolled into this study and randomized to receive on weekly basis either 40 mg/m 2 cisplatin (Control Group: 30 patients) or 50 mg/m 2 paclitaxel (Study Group: 30 patients) concurrently with radiotherapy total dose for radiotherapy 80 Gy for both the groups (50 Gy from EBRT and 30 Gy from HDR brachytherapy). Followup time was 6 months. RESULTSThe mean number of chemotherapy cycles was comparable with 86.7% and 80% of patients receiving 5 doses in control and study group respectively. At the completion of treatment 20 patients (66.7%) in control group and 15 patients (50%) in study group had complete response; 10 patients (33.3%) in control group and 15 patients (50%) in study group had partial response. After 6 months of followup, 23 patients (76.7%) in control group and 19 (63.3%) patients of study group had complete response and 7 (23.4%) patients of control group and 10 (33.4%) patients of study group had partial response respectively. One patient of study group developed progressive disease during followup period. CONCLUSIONThis small prospective study shows that weekly paclitaxel does not provide any clinical advantage over weekly cisplatin for concurrent chemoradiation for locally advanced carcinoma cervix and associated with more gastrointestinal and haematological toxicities.

Background- The study aimed to assess the safety and efficacy of temozolomide along with whole brain radiotherapy in brain metastasis and compare with the efficacy and safety of WBRT alone.Methodology- This study was conducted as a prospective study at Department of Radiotherapy, NSCB Medical College Jabalpur during the study period of 20 months among 34 radiologically and histologically proven case of brain metastasis patients. All the patients were randomly divided into two groups cases (WBRT with TMZ) and controls (WBRT). Two groups were compared for radiological response, symptoms and adverse reactions weekly upto 6 weeks. Results- In week 2, hematological derangement were observed in significantly higher proportions of cases as compared to control (p<0.05). Vomiting and seizure was noted in significantly higher proportions of controls at week 4 following treatment (p<0.05). Though the radiological response was better in cases but the observed difference between cases and controls was statistically insignificant (p>0.05). Conclusions-Brain metastasis following primary cancer are commonly observed in cancer clinics. WBRT is given for palliative treatment in such patients. However, addition of TMZ had shown symptomatic improvement in patients with brain metastasis. Though, adverse events especially hematological were reported in higher proportions with TMZ, but these adverse effects could be effectively managed. Overall, TMZ is associated with good response rate. Thus, it can be added to WBRT to improve the survival rate and response rate in patients with brain metastasis.