外照射治疗与大剂量近程放疗同时联合顺铂与紫杉醇化疗治疗晚期宫颈癌

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Objective. The aim of the present study was to evaluate toxicity and efficacy of concurrent chemoradiation with cisplatin and paclitaxel and high-dose rate (HDR) brachytherapy in patients with locally advanced cervical cancer. Patients and methods. 19 patients with locally advanced cervical carcinoma were treated with external beam radiotherapy (EBRT) to the pelvis ±para-aortic nodes, HDR brachytherapy, cisplatin at doses of 50 mg/m2 in weeks 1 and 4, and weekly paclitaxel at 50 mg/m2 in weeks 1-5 during years 2000-2002. Chemotherapy was administered until leukopenia ≤2500/mm3, thrombocytopenia < 100,000/mm3, and/or hemoglobin level < 100 g/l occurred. The median follow up was 36 months (range 25-47). Results. Only four patients were able to tolerate the complete intended course of radiochemotherapy. Chemotherapy was stopped in two patients because of allergic reaction and in one patient because of deep thrombosis. In 12 other cases, chemotherapy was discontinued for hematological toxicity. The 3-year disease free survival was 66%, the 3-year overall survival was 74%. Conclusion. The hematological toxicity was the main factor limiting administration of cisplatin at 50 mg/m2 in weeks 1 and 4 and weekly paclitaxel at 50 mg/m2 in weeks 1-5 concomitantly with extended field radiotherapy of locally advanced cervical carcinoma. Objective. The aim of the present study was to assess toxicity and efficacy of concurrent chemoradiation with cisplatin and paclitaxel and high-dose rate (HDR) brachytherapy in patients with locally advanced cervical cancer. Patients and methods. 19 patients with locally advanced cervical carcinoma were treated with external beam radiotherapy (EBRT) to the pelvis ± para-aortic nodes, HDR brachytherapy, cisplatin at doses of 50 mg / m2 in weeks 1 and 4, and weekly paclitaxel at 50 mg / m2 in weeks 1-5 during years 2000 The median follow up was 36 months (range 25-47). The median follow up was 36 months (range 25-47). Results Four patients with leukemia ≤ 2500 / mm3, thrombocytopenia <100,000 / mm3, and / or hemoglobin level <100 g / were able to tolerate the complete intended course of radiochemotherapy. Chemotherapy was stopped in two patients because of allergic reaction and in one patient because of deep thrombosis. In 12 other cases, chemotherapy was discontinued for hematological t The 3-year disease free survival was 66%, the 3-year overall survival was 74%. Conclusion. The hematological toxicity was the main factor limiting administration of cisplatin at 50 mg / m2 in weeks 1 and 4 and weekly paclitaxel at 50 mg / m2 in weeks 1-5 concomitantly with extended field radiotherapy of locally advanced cervical carcinoma.
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