Incidence and temporal pattern of anorexia, diarrhea, weight loss, and leukopenia in patients with cervical cancer treated with concurrent radiation therapy and weekly cisplatin: comparison with radiation therapy alone.
OBJECTIVE
To investigate the temporal patterns of anorexia, diarrhea, weight loss, and leukopenia in chemoradiation therapy (CRT) for cervical cancer compared with radiation therapy (RT) alone.


METHODS
Acute toxicities in 43 patients receiving RT alone and 40 patients receiving CRT were retrospectively analyzed. Patients were treated with a combination of external beam irradiation and high-dose rate intracavitary irradiation. Cisplatin was given once a week for 5 weeks concurrently with the external beam irradiation. CRT was divided into low-dose CRT group (cisplatin, 20-30 mg/m(2), n = 16) and high-dose CRT group (cisplatin, 35-40 mg/m(2), n = 24). Toxicities were evaluated before, every week up to 7 weeks during the cycle, and 12 weeks after initial irradiation, according to the National Cancer Institute Common Toxicity Criteria version 2.


RESULTS
In the high-dose CRT group, anorexia during the first 5 weeks, leukopenia after 5 weeks, and weight loss after 3 weeks were significantly higher than those in the RT alone group. In the low-dose CRT group, anorexia between 1 and 2 weeks, leukopenia after 5 weeks, and weight loss between 3 and 4 weeks were significantly higher than those in the RT alone group. Diarrhea between 1 and 2 weeks in the high-dose CRT group (P = 0.037, P = 0.025) and between 2 and 3 weeks in the low-dose CRT group (P = 0.015, P = 0.036) was significantly lower compared with RT alone.


CONCLUSIONS
These data can help us understand when patients are likely to develop maximal toxicities and to manage them with optimal timing.
Ohno
Tatsuya
T
Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Chiba 263-8555, Japan. t_ohno@nirs.go.jp
Kato
Shingo
S
Wakatsuki
Masaru
M
Noda
Shin-Ei
SE
Murakami
Chiemi
C
Nakamura
Misako
M
Tsujii
Hirohiko
H
D000367:Age Factors; D000368:Aged; D000855:Anorexia / Q000139:chemically induced / Q000209:etiology*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001918:Brachytherapy / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy / Q000009:adverse effects; D003967:Diarrhea / Q000139:chemically induced / Q000209:etiology*; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced / Q000209:etiology*; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D015431:Weight Loss / Q000187:drug effects / Q000528:radiation effects
D000970:Antineoplastic Agents; D002945:Cisplatin