The TMH doctors said with India seeing 60 to 70% of cervical cancer patients in locally advance stage, the two studies are path breaking as it shows better cure rate when compared to the traditional cervical cancer treatment methods.
The studies, which have now set up a benchmark for cervical cancer treatment in advance stages worldwide, have emphasised the need to have a robust radiation facility that supports both external and internal radiation across the country.
The first study, led by Dr Sudeep Gupta, Medical Oncologist at TMC and General Secretary of Women’s Cancer Initiative, was presented to worldwide acclaim at the plenary session of one of the world’s top cancer conferences, European Society of Medical Oncology (ESMO) on 10th September 2017 and published as a full report on 11th February 2018 in the prestigious Journal of Clinical Oncology.
The team of researchers, comprising members of the Gynaecologic Oncology Group of TMC, showed in a randomised controlled trial, that women with locally advanced cervical cancer up to stage 2 had a higher cure rate when treated with simultaneous chemotherapy and radiotherapy compared to chemotherapy and surgery.
This is the first ever study to have compared these two treatment strategies and this result has changed and defined the treatment of this cancer worldwide. Of note, cervical cancer continues to be the most common cancer in Indian women with about 130,000 new cases every year, who are likely to benefit from this result. Unfortunately, about three-fourths of these patients continue to present with locally advanced cancers. The funding support for this important study was provided by the Department of Atomic Energy, Government of India, through Tata Memorial Centre.
“There has been a long standing controversy about the appropriate treatment of women with stage 1B and 2, locally advanced cervical cancer. Depending on which doctor these patients consulted first, they were either treated with simultaneous chemotherapy and radiotherapy or with chemotherapy followed by surgery. No one was certain about which treatment resulted in higher cure rates. Our study has laid this controversy to rest – women with stage 1B and 2 cervical cancer should be offered chemo-radiotherapy as the standard option. We urge all state governments to provide adequate radiotherapy facilities for women, including those residing in rural areas, close to their homes,” said Dr Gupta.
The second study, led by Dr Shyam Srivastava and Dr Umesh Mahantshetty, Radiation Oncologists at TMC, was also presented at a prestigious international conference, the European Society of Gynaecologic Oncology (ESGO) in November 2017 and published as a full report in the prestigious JAMA Oncology.
This is a sister study in women with even more advanced cervical cancer – stage 3, which, unfortunately is still common in India. The investigators compared two treatment strategies – radiotherapy alone or radiotherapy with simultaneous chemotherapy, in these patients. It was shown by them that addition of once per week chemotherapy to radiotherapy resulted in significant reduction in cancer relapse and death in these women. This study was intramurally funded by Tata Memorial Centre.
Dr Mahantshetty further said there was uncertainty about whether addition of chemotherapy, over and above radiotherapy, will lead to better outcomes in women with most advanced stages of cervical cancer. “Our study shows that cure rate and survival jumps when you add chemotherapy. I join Dr Gupta in urging all stakeholders to make radiation equipment and chemotherapy widely available for treatment of underprivileged women with cervical cancer,” said Dr Mahantshetty.