Thromboembolic events in patients treated with definitive chemotherapy and radiation therapy for invasive cervical cancer.
OBJECTIVE
Determine the incidence of and risk factors for thromboembolic events (TE) in patients treated with definitive chemoradiation for cervical cancer at our institution.


METHODS
A retrospective chart review was performed of all patients with a diagnosis of invasive carcinoma of the cervix (FIGO Stage IB-IVA) treated with definitive chemoradiation at University of Iowa Hospitals and Clinics (UIHC) from July 2002 to December 2003. Forty-eight patients met these criteria. All but one patient received 45 Gy to the pelvis followed by brachytherapy, IMRT, or conformal boost. One patient received 39.6 Gy to the pelvis. Cisplatin chemotherapy, 40 mg/m squared, was given weekly for 6 weeks. Data were collected for FIGO stage, age, body mass index (BMI), and smoking history. TE were confirmed by Doppler ultrasound or pulmonary imaging. Log-rank tests were used to examine the association between time to TE and the variables FIGO stage and smoking status. The association between time to TE and the continuous variables age and BMI was examined with Cox proportional hazards regression. All tests were two-sided and carried out to the 5% level of significance using the SAS statistical software package.


RESULTS
Minimum follow-up was 8 months. Eight patients (16.7%) developed a TE. The associations were not statistically significant for stage (P = 0.72), smoking status (P = 0.72), age (P = 0.63) or BMI (P = 0.86). Risk factors were similar in both groups. Data review suggests that the entire group had risk factors for TE.


CONCLUSIONS
We noted a high incidence of TE (16.7%) in patients treated at UIHC with chemoradiation for invasive cervical cancer. We did not find a statistical association between age, stage, smoking history, or BMI and risk of TE in this group. Patients with and without TE had multiple risk factors for TE.
Jacobson
Geraldine M
GM
Gynecological Oncology, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, W 189Z General Hospital, 200 Hawkins Drive, Iowa City IA 52242, USA. geraldine-jacobson@uiowa.edu
Kamath
Reena S
RS
Smith
Brian J
BJ
Goodheart
Michael J
MJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects; D012307:Risk Factors; D013923:Thromboembolism / Q000139:chemically induced / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy