A short weekly chemotherapy course with two inexpensive medicines given ahead of standard chemoradiation treatment can significantly improve survival in locally advanced cervical cancer, a global clinical trial with patients in Calcutta has demonstrated.

The trial that recruited patients from the Chittaranjan National Cancer Institute (CNCI) and the Saroj Gupta Cancer Centre has shown increases in both disease-free survival and overall survival rates and prompted oncologists to advocate adoption of the revised treatment protocol.

Cervical cancer is the second most common cancer among women in India. Experts estimate that 90,000 women develop cervical cancer in India annually. In locally advanced cervical cancer (LACC), the tumour has grown beyond the cervix into local neighbouring tissues.

The standard treatment for LACC involves a medicine called cisplatin given alongside radiotherapy — the concurrent treatment also called chemoradiation. The trial led by researchers at the University College London Hospital evaluated the impact of giving two anti-cancer drugs named carboplatin and paclitaxel once weekly for six weeks — a protocol called induction therapy — before chemoradiation.

The five-year disease-free survival rate was 73 per cent in women who received the induction therapy before chemoradiation, compared with 64 per cent in women who received only chemoradiation. The overall five-year survival rate was 80 per cent in women who received induction therapy before chemoradiation, compared with 72 per cent in women who received only chemoradiation.

The researchers have said induction chemotherapy should be considered as a “new standard of care”.

Doctors who were not associated with the study have also said the results are impressive. “This is good evidence that is easily implementable. The cost of (the additional) intervention is not high and efficacy is beyond doubt. It should be adopted globally,” said Rajendra Badwe, director of the Tata Memorial Centre, Mumbai.

A key feature of induction therapy is its low cost that doctors say would enable its use in public and private hospitals.

“It would typically cost Rs 2,000 per cycle. Patients received six cycles. The total cost of the therapy including supportive care at government subsidised rates would be about Rs 15,000,” CNCI director Jayanta Chakrabarti told The Telegraph.

Six patients at the CNCI and four patients at the Saroj Gupta Cancer Centre participated in the trial that recruited 500 patients from 32 centres in five countries. But some oncologists caution that a larger study may be required to validate the findings.

“The trial size is relatively small with only 500 patients. But these are promising results that should ideally be replicated through more studies,” said Sudeep Gupta, director of the Advanced Centre for Treatment Research and Education in Cancer, Navi Mumbai.

Appropriate and timely treatment for cervical cancer remains a major challenge in India. A nationwide study by the National Institute of Disease Informatics and Research, Bangalore, has found that while cervical cancer survival rates have increased across the country, the national average five-year survival rate remains 52 per cent amid wide disparities across different cities and towns and urban and rural areas.