Article Sidebar
Views PDF: 60
SAFETY AND PRELIMINARY EFFICACY OF CONCURRENT CHEMORADIATION WITH CISPLATIN EVERY 3 WEEKS IN LOCALLY ADVANCED CERVICAL CANCER AT K HOSPITAL
Main Article Content
Abstract
Background: We aimed to assess the safety and preliminary efficacy of cisplatin every 3 weeks in concurrent chemoradiation in cervical cancer. Methods: This is an interventional study which included patients with stage IB3-IVA cervical cancer at Vietnam National Cancer Hospital. Neuroendocrine carcinoma was excluded. Patients were treated with definitive chemoradiotherapy with cisplatin 75mg/m2, day 1, 22 and 43 concurrently with external beam radiotherapy and brachytherapy. Treatment completion rate, response rate and toxicities were assessed. Results: A total of 38 patients were included, with a mean age of 53.3 years (range 33-71). The mean tumor size was 4.31 ± 0.87 cm. Stage IB3, II and III accounted for 2.6%, 44.7% and 52.6% respectively. Thirty-seven patients (97.3%) completed planned treatment protocol, with the mean total time of radiation therapy of 49.8 ± 5.9 days. At 1 month after treatment, the complete clinical response rate was 84.2% (32/38 patients), at 3 months, this rate was 97.4%. Grade 3 toxicity included neutropenia (15.8%) and vomiting (13.2%), no febrile neutropenia or life-threatening toxicities were recorded. Conclusion: Concurrent chemoradiation with cisplatin every 3 weeks is a safe and feasible therapy for locally advanced cervical cancer infusion unit. A larger randomized controlled trial should be done to confirm the efficacy of the 3-weekly schedule.
Article Details
References
2. Chemoradiotherapy for Cervical Cancer Meta-Analysis Collaboration. Reducing uncertainties about the effects of chemoradiotherapy for cervical cancer: a systematic review and meta-analysis of individual patient data from 18 randomized trials. J Clin Oncol. 2008;26(35): 5802-5812. doi: 10.1200/ JCO.2008.16.4368
3. Whitney CW, Sause W, Bundy BN, et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes: a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol. 1999;17(5): 1339-1348. doi: 10.1200/JCO.1999.17.5.1339
4. Keys HM, Bundy BN, Stehman FB, et al. Cisplatin, radiation, and adjuvant hysterectomy compared with radiation and adjuvant hysterectomy for bulky stage IB cervical carcinoma. N Engl J Med. 1999;340(15):1154-1161. doi:10.1056/NEJM199904153401503
5. M M, Pj E, J L, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. The New England journal of medicine. doi:10.1056/NEJM199904153401501
6. Ryu SY, Lee WM, Kim K, et al. Randomized clinical trial of weekly vs. triweekly cisplatin-based chemotherapy concurrent with radiotherapy in the treatment of locally advanced cervical cancer. Int J Radiat Oncol Biol Phys. 2011;81(4):e577-581. doi:10.1016/j.ijrobp.2011.05.002
7. Mitsuhashi A, Uno T, Tanaka N, et al. Phase I study of daily cisplatin and concurrent radiotherapy in patients with cervical carcinoma. Gynecol Oncol. 2005;96(1):194-197. doi: 10.1016/ j.ygyno.2004.09.038
8. Gargiulo P, Arenare L, Pisano C, et al. Long-Term Toxicity and Quality of Life in Patients Treated for Locally Advanced Cervical Cancer. Oncology. 2016; 90(1): 29-35. doi:10.1159/ 000441226
9. Souhami L, Seymour R, Roman TN, et al. Weekly cisplatin plus external beam radiotherapy and high dose rate brachytherapy in patients with locally advanced carcinoma of the cervix. Int J Radiat Oncol Biol Phys. 1993;27(4):871-878. doi:10.1016/0360-3016(93)90462-5
10. Ngô Thanh Tùng và cộng sự., “Đánh giá kết quả điều trị hóa xạ trị đồng thời theo sau hóa chất cảm ứng trên nhóm bệnh nhân ung thư vòm giai đoạn III và IVA,” Bệnh viện K, Đề tài nghiên cứu cấp cơ sở, 12/2021.