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A prospective Phase I study to determ ine toxicity of con-current weekly intravenous cisplatin /whole abdominopelvic radiation therapy followed by four c ycles of intravenous doxorubicin /cisplatin chemothera py.Ten patients with advanced endometrial cancer confin ed to the abdominal cavity and /or paraaortic lymph nodes with small residual disease were treated postoperatively with 3000cGy whole abdominopelvic irradiation combin ed with 1500cGy boost to the pelvis or pelvic and aortic fie lds.Cisplatin 15mg /m 2 was given every week during irradiation.After completing radiotherapy,patients were to rece ive doxorubicin 50mg /m 2 and cisplatin 50mg /m 2 every 3weeks for four cycles.Graduated dose reduction and accele ration of the doxoru-bicin dose were specified depending upon hematologic toxicity.Toxicities were monitore d with weekly laboratory studies during treatment and frequent examinations.Five patients with Stage IIIC(paraaortic node involvement )-and five with Stage IVB disease were t reated on this study.Acute toxicity during chemoirradia tion included one patient with grade 4neutropenia and one patient with persistent grade 1thrombocytopenia.Seven patients received chemotherapy after completing radi ation therapy,two pro-gressed before chemotherapy,and on e had thrombocy-topenia.Toxicity during chemotherapy included grade 4neutropenia in all patients with fou r having five episodes of febrile neutropenia.Despite doxorubicin dose reductions for hematologic toxicity,three patients exhibited grade 4neutropenia after both the second an d third cycles.One patient developed a small bowel obstruction from radiation therapy that required surgery.There were no treatment -re-lated deaths.Overall median surviv al was 14months,with only one long -term survivor free of disease at 58months.Without cytokine support,whole abdominopelvic irradiation and concurrent weekly cisplatin followed by doxorubicin /cisplatin chemotherapy without cytokine support has pro-hibitive hematologic toxicity.
A prospective Phase I study to determine ine toxicity of con-current weekly intravenous cisplatin / whole abdominopelvic radiation therapy followed by four c ycles of intravenous doxorubicin / cisplatin chemothera py.T. Ten patients with advanced endometrial cancer confin ed to the abdominal cavity and / or paraaortic lymph nodes with small residual disease were treated postoperatively with 3000 cGy whole abdominopelvic irradiation combin ed with 1500 cGy boost to the pelvis or pelvic and aortic fie lds.Cisplatin 15 mg / m 2 was given every week during irradiation. After radiotherapy, patients were to receve doxorubicin 50 mg / m 2 and cisplatin 50 mg / m 2 every 3 weeks for four cycles. Dravated dose reduction and accelerated ration of the doxoru-bicin dose were specified depending upon hematologic toxicity. Toxicities were monitore d with weekly laboratory studies during treatment and frequent examinations. Five patients with Stage IIIC (paraaortic node involvement) -and five with Stage IVB disease were t reated on this study. Acute toxicity during chemoirradiation included one patient with grade 4 neutropenia and one patient with persistent grade 1 thrombocytopenia. Seventh patients received chemotherapy after completing radiotherapy therapy, two pro-gress before chemotherapy, and on e thrombocytopenia . Toxicity during treatment included grade 4 neutropenia in all patients with fou r having five episodes of febrile neutropenia. Desirably doxorubicin dose reductions for hematologic toxicity, three patients exhibiting grade 4 netropenia after both the second an d third cycles. One patient developed a small bowel obstruction from radiation therapy that required surgery. There were no treatment -re-lated deaths.Overall median surviv al was 14months, with only one long -term survivor free of disease at 58months.Without cytokine support, whole abdominopelvic irradiation and concurrent weekly cisplatin followed by doxorubicin / cisplatin chemotherapy without cytokine support has pro-hibitive hematologic toxicity.