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Category: Volume 08 Issue 01 January 2020
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Title: Retrospective Analysis of Curcumin in Cervical Cancer Patients Post Radiotherapy

Authors: Nisarga Vontikoppal Manjunatha, Divyashree Shivalingaiah Jayashankar, Harshitha Kesargere Ramesh, Anu Kodihalli Raju, Vijayalaxmi Patil, Lokesh Vishwanath, Naveen Thimmiah, Sridhar Poojar, Vijay Calmuge Raghu

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.83

Abstract

Aim of the Study: To Evaluate the Effect of Curcumin on Toxicity and Outcomes in Cervical Cancer patients Post Radiotherapy.

Material and Methods: 60 Cervical Cancer patients who received definitive Chemo radiation and Brachytherapy were selected for the study. Patients received External beam Radiotherapy by 3DCRT technique to a total dose of 45-50GY with concurrent Platinum based chemotherapy of 5cycles and Brachytherapy was delivered by HDR technique, limiting the Bladder and Rectal doses to 75-80GY and 70-75GY respectively.

Of these, 30 Patients received Tab. Curcumin 500mg BID for a minimum period of 3 months post Radiotherapy during Follow-up and were compared with patients of similar characteristics kept only under Observation. The toxicity and outcomes post Radiotherapy was analyzed. The incidence of Radiation Dermatitis, Radiation Cystitis and Radiation Proctitis was analyzed.

Results: At 3 months post Radiotherapy, Radiation Dermatitis was seen in 20 out of 30 patients in the observation arm with Grade I toxicity in 12 patients, Grade II toxicity in 6 patients and Grade III toxicity in 2 patients compared to12 patients  having Grade I toxicity who received Curcumin (p=0.038) which was significant. Radiation Cystitis was seen in 21 patients in the observation arm with Grade I Toxicity in 16 Patients, Grade II Toxicity in 4 Patients and Grade IV Toxicity in 1patientcompared to 12patients with Grade I Cystitis in Curcumin arm (p=0.0198) which was  significant. Radiation Proctitis was seen in 23 patients in the observation arm with Grade I toxicity in 14 Patients and Grade II Toxicity in 9 patients compared to 8 patients with Grade I proctitis and 1 patient with Grade II toxicity in Curcumin arm (p=0.001) which was significant. There was no evidence of disease in 25 patients and only 5 patients had Stable disease in Curcumin arm compared to 6patients with Stable disease and 4patients with Progressive disease and no evidence of disease was seen in 20 patients in Observation arm.

Conclusions: Radiation Dermatitis, Cystitis and Proctitis are well known complications of radiation treatment in Carcinoma Cervix patients. Early detection and treatment reduces the grade of toxicity and improves Quality of life. The use of Curcumin post radiation definitely reduces the side effects and thereby improves the therapeutic ratio. Better local control with Curcumin must also be proved with large randomized control trials addressing all the bias. With the advent of nano-curcumin there is better absorption and bio- availibility for enhanced effects of curcumin and improving the quality of life.  The optimal dosage and duration of curcumin post radiotherapy to be administered is still investigational.

Keywords: Curcumin, Dermatitis, Cystitis, Proctitis, Cervical Cancer, Radiotherapy.

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Corresponding Author

Anu Kodihalli Raju

Post Graduate, Department of Radiation Oncology, Kidwai Memorial Institute of Oncology, Bengaluru-29