External beam radiotherapy and high-dose brachytherapy combined with cisplatin and paclitaxel in patients with advanced cervical carcinoma

• Published in: Gynecologic oncology Vol. 99; no. 2; pp. 334 - 338
• Main Authors: Petera, Jiří, Odrážka, Karel, Frgala, Tomáš, Špaček, Jiří
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2005
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Brachytherapy - adverse effects; Brachytherapy - methods; Cisplatin; Cisplatin - administration & dosage; Cisplatin - adverse effects; Combined Modality Therapy; Dose-Response Relationship, Radiation; External beam radiotherapy; Female; Follow-Up Studies; Hematologic Diseases - chemically induced; Humans; Middle Aged; Paclitaxel; Paclitaxel - administration & dosage; Paclitaxel - adverse effects; Retrospective Studies; Survival Rate; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - radiotherapy; Cisplatin; Paclitaxel; External beam radiotherapy
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2005.06.015

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.
19 patients with locally advanced cervical carcinoma were treated with external beam radiotherapy (EBRT) to the pelvis ± paraaortic nodes, HDR brachytherapy, cisplatin at doses of 50 mg/m
2 in weeks 1 and 4, and weekly paclitaxel at 50 mg/m
2 in weeks 1–5 during years 2000–2002. Chemotherapy was administered until leukopenia ≤2500/mm
3, thrombocytopenia <100,000/mm
3, and/or hemoglobin level <100 g/l occurred. The median follow up was 36 months (range 25–47).
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%.
The hematological toxicity was the main factor limiting administration of cisplatin at 50 mg/m
2 in weeks 1 and 4 and weekly paclitaxel at 50 mg/m
2 in weeks 1–5 concomitantly with extended field radiotherapy of locally advanced cervical carcinoma.