Concurrent chemoradiotherapy with low-dose daily cisplatin for high risk uterine cervical cancer: a long-term follow-up study
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Authors
Ushijima, Kimio
Fujiyoshi, Keizo
Kawano, Kouichiro
Tsuda, Naotake
Nishio, Shin
Eto, Hidehiro
Kamura, Toshiharu
Issue Date
2013-04-05
Type
Article
Language
en_US
Keywords
Cervical Cancer , Cisplatin , Concurrent Chemoradiotherapy , Daily Low-Dose
Alternative Title
Abstract
Objective:
To evaluate the clinical efficacy of concurrent chemoradiotherapy (CCRT) using daily low-dose cisplatin for cervical cancer.
Methods:
Fifty-one patients with locally advanced cervical cancer (FIGO stage IB2, bulky IIA, IIB-IVA) who were treated with CCRT as primary therapy at Kurume University Hospital between 2000 and 2007 were retrospectively reviewed. CCRT consisted of 5 mg/m2/day of cisplatin 5 days per week, and external beam radiotherapy (EBRT) administrated to whole pelvis to 45-50.6 Gy. High-dose-rate intracavitary brachytherapy was delivered in a single dose of 4-5 Gy at point A, once a week after 20-30 Gy of EBRT.
Results:
The median follow-up duration was 42 months (range, 5 to 116 months). The overall response rate was 94.1%. Five year overall survival rate was 71.5% and 46.2% in stage I or II, and stage III or IVA, respectively. During follow-up period, 30 recurrences (58.8%) were found, the local failure rate was 39%, and distant failure rate was 35.2%, and both (local and distant) were 15.7%. Hematological toxicities were the most frequent acute toxicities. Grade 3 and 4 neutropenia was observed in 37.3%. Late intestinal toxicities appeared in 7 cases (13.7%), which occurred between 6 and 114 months after treatment. Four cases required bowel surgery.
Conclusion:
CCRT using daily low-dose cisplatin was tolerable and showed favorable initial response as the primary therapy for locally advanced uterine cervical cancer. But there was no remarkable long-term benefit for patients' survival or local disease control in this study. The incidence of late intestinal toxicity still requires further investigation.
Description
Citation
Ushijima, K., Fujiyoshi, K., Kawano, K., Tsuda, N., Nishio, S., Eto, H., & Kamura, T. (2013). Concurrent chemoradiotherapy with low-dose daily cisplatin for high risk uterine cervical cancer: a long-term follow-up study. Journal of gynecologic oncology, 24(2), 108–113. https://doi.org/10.3802/jgo.2013.24.2.108
Publisher
Journal of Gynecologic Oncology