Comparative evaluation of hypofractionated radiotherapy and conventional fractionated radiotherapy in the management of carcinoma of the cervix in Ibadan, Nigeria.

Four hundred and eighty patients with histologically confirmed carcinoma of the uterine cervix were randomized into 2 groups to either receive hypofractionated radiotherapy (HF--230 patients--study group) or conventional fractionated radiotherapy (CFR--250 patients--control group) between December 1988 and November 1992 at the Radiotherapy Department, University College Hospital, Ibadan. The 5-year survival rate for HF patients in Stages I, II, III and IV were, respectively, 91.3%, 67.2%, 40.2% and 18.0% while for CFR patients in Stages I, II, III and IV were respectively, 92.8%, 69.2%, 42.5% and 19.6%. Though early radiation adverse effects were similar in CFR and HF patients, marked late adverse radiation effects were observed in HF patients than in CFR patients. Complete response rate and local tumour controls were found to be similar in the HF and CFR patients. This study revealed that with similar 5-year survival, complete response rate and local tumour control in HF and CFR patients while a significantly higher late radiation adverse effects were recorded in HF patients, conventional fractionated radiotherapy is the preferred form of radiation therapy in the management of carcinoma of the uterine cervix. Administration of hypofractionated radiotherapy for cervical cancer patients with the aim of maximizing the use of few available radiotherapy facilities, as currently obtained in some radiotherapy centres in Nigeria will result in high post treatment morbidity.