M. Awol, and T. Z. Chema; Addis Ababa university, addis ababa, Ethiopia
Purpose/Objective(s):: Cervical cancer is the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women. Most patients in Ethiopia and other parts of Africa present with advanced stage and curative treatment is not possible. The aim of this study is to assess the symptom response and treatment-related toxicities in advanced cervical cancer patients treated with the QUADSHOT regimen. Materials/
Methods: : This prospective cohort study accrued patients with advanced cervical cancer deemed unsuitable for radical chemo radiation due to advanced stage metastatic disease and/or patient refusal between February and November 2022. Patients were treated with a QUADSHOT radiotherapy regimen (3.7Gy per fraction twice a day, 6 hours apart on Saturday and Sunday only, every 21 days, to a total dose of 44.4Gy). Symptom response at 2 months, 3 months and 6 months after treatment and associated acute and subacute toxicity were assessed. Results: The mean age of the 53 enrolled patients was 56 years (SD, 10.4). The majority 43(81%) of patients had stage IIIB-IVB disease. Of the 50 patients assessed at 2 months, 43(86%) had a complete response (CR) from vaginal bleeding, 36 (72%) from vaginal discharge, and 25 (50%) from pelvic pain. In the 3rd-5th months, 46 patients assessed, CR rates were 42 (91%), 37(80%), and 29(63%) for vaginal bleeding, vaginal discharge, and pelvic pain respectively. In the sixth month 19 patients assessed, CR rates were 18 (94%), 17(89%, and 13(68%), respectively. There was no grade 3 or higher acute toxicity. Conclusion: QUADSHOT regimen has rapid symptom relief for patients with advanced cervical cancer, with minimal toxicities. In settings with restricted resources, the QUADSHOT regimen is recommended for symptom palliation
