title: Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: a comparative study between prolonged oral cyclophosphamide and oral Etoposide.
abstract: OBJECTIVE
  To compare the efficacy and toxicities of low-dose oral cyclophosphamide and oral etoposide in patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy.
  
  
  METHODS
  30 patients with recurrent and persistent cervical cancer with gross pelvic disease were enrolled in this trial. The patients were randomly divided into two groups of 15 patients each with one group receiving low dose oral cyclophosphamide (100 mg/day) and the other group receiving low-dose oral etoposide (50 mg/day). Results were statistically analysed by IBM SPSS Statistics 19.
  
  
  RESULTS
  Oral etoposide was not well tolerated with grade 2 neutropenia occurring in 33.3% and grade 3 neutropenia in 6.6% and thrombocytopenia occurring in 13.3%. Oral cyclophosphamide group on the other hand was better tolerated with none of the patients having thrombocytopenia and 6.6% patients having grade 2 neutropenia. There were two complete response (15.38%) and one partial response at the end of study (7.6%) in the cyclophosphamide group whereas there was no complete response and two partial response (16.6%) in the oral etoposide group.
  
  
  CONCLUSIONS
  Long-term, low-dose oral etoposide was found to be less tolerated without any significant effect with patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy in contrast to oral cyclophosphamide which was found to be effective and well-tolerated by the patients.
authors.affiliation: Department of Gynaecologic Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
authors.forename: Upasana
authors.initials: U
authors.lastname: Baruah
authors.affiliation: Department of Gynaecologic Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
authors.forename: Debabrata
authors.initials: D
authors.lastname: Barmon
authors.affiliation: Department of Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
authors.forename: Munlima
authors.initials: M
authors.lastname: Hazarika
authors.affiliation: Department of Gynaecologic Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Deka
authors.affiliation: Department of Gynaecologic Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
authors.forename: Amal Chandra
authors.initials: AC
authors.lastname: Kataki
authors.affiliation: Department of Gynaecologic Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India.
authors.forename: Sushruta
authors.initials: S
authors.lastname: Shrivastava
keywords: Metronomic therapy; Oral cyclophosphamide; Oral etoposide; Recurrent carcinoma cervix