Treatment results of incomplete chemoradiotherapy in locally advanced cervical cancer
Ying Gao,1,* Fei Gao,2,* Zi Liu,1 Li-ping Song1
1Department of Radiotherapy Oncology, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Second Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China
*These authors contributed equally to this work
Objective: Regimens that combine chemotherapy and radiotherapy increase toxicity and compromise a patient’s ability to adhere to the treatment plan. We evaluated the efficacy and safety of a partially completed chemoradiation regimen prescribed for locally advanced carcinoma of the cervix.
Methods: Medical records of 156 patients with locally advanced cervical cancer stage IIB–IVA who received chemoradiation with cisplatin (40 mg/m2) and 5-fluorouracil (500 mg/m2) from October 2006 to October 2008 were collected. The treatment protocol called for two cycles of chemotherapy. External beam radiation therapy was administered using a 10-MeV electron beam. Local control, disease free survival, overall survival, and toxicities were evaluated.
Results: With a median follow-up of 37.5 months, 89 patients (57%) completed the planned protocol. Sixty seven patients (43%) completed fewer than two cycles. The 3-year local control rate was significantly better in the patient group that completed the prescribed plan (92.1% compared to 80.6%; P = 0.033). No statistical significance was observed between the groups that completed or did not complete the two cycle protocol with regard to disease free survival (80.9% and 73.2%, respectively; P = 0.250), overall survival (84.3% and 79.1%; P = 0.405), and progression survival (3.4% and 3.0%; P = 0.892). Differences in acute hematologic toxicity and subcutaneous toxicity were observed between the two groups.
Conclusions: Completion of two cycles of 5-fluorouracil and cisplatin with radiotherapy was effective, safe, and responsible for better local control; toxicity was acceptable. Disease free survival and overall survival were similar between the treatment groups.
Keywords: cervical cancer, chemoradiotherapy, 5-fluorouracil, cisplatin, local control, toxicity
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]