Concurrent chemo-radiation induced renal and haematological toxicities in patients with invasive cervical cancer undergoing treatment

Abstract

Background. Cervical cancer constitutes a major problem in women’s health in South Africa (SA). Concurrent chemo-radiation is the standardised treatment for patients with invasive cervical cancer. There is limited evidence on the differences in the concurrent chemo-radiation treatment toxicity between HIV-positive and HIV-negative patients.

Objective. To determine the renal and haematological toxicities associated with concurrent chemo-radiation in women undergoing treatment for invasive cervical cancer, using renal and haematological biomarkers.

Methods. A prospective study was conducted among 82 women that presented for concurrent chemo-radiation treatment at the Inkosi Albert Luthuli Central Hospital in SA. Thirty two (39%) of participants were HIV-positive. Data collected using questionnaires and the hospital’s databases were analysed with SPSS data analysis software. Toxicity was scored using the Cooperative Group Common Toxicity Criteria.

Results. More than 90% of both HIV-positive and HIV-negative participants completed all 5 cycles of chemotherapy. The main finding in both cohorts was Grade 1 and 2 haematological toxicity. Haemoglobin was significantly decreased in 74% of participants. No renal toxicity was identified in this study. The reasons for not completing treatment were abscondment during treatment (3%) and discontinuation of treatment by the physician (1%).

Conclusion. Concurrent chemo-radiation was well tolerated in both HIV-positive and HIV-negative participants. The same concurrent chemo-radiation protocol can be applied to both HIV-positive and HIV-negative patients. However, the study population was small and findings need to be replicated in more extensive studies.