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


METHODS
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/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 < or = 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%.


CONCLUSIONS
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.
Petera
Jirí
J
Department of Oncology and Radiotherapy, Charles University Medical School and Teaching Hospital, Sokolská 408, 500 05 Hradec Králové, Czech Republic. petera@fnhk.cz
Odrázka
Karel
K
Frgala
Tomás
T
Spacek
Jirí
J
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*
D017239:Paclitaxel; D002945:Cisplatin