Clinical outcome in posthysterectomy cervical cancer patients treated with concurrent Cisplatin and intensity-modulated pelvic radiotherapy: comparison with conventional radiotherapy.
OBJECTIVE
To assess local control and acute and chronic toxicity with intensity-modulated radiation therapy (IMRT) as adjuvant treatment of cervical cancer.


METHODS
Between April 2002 and February 2006, 68 patients at high risk of cervical cancer after hysterectomy were treated with adjuvant pelvic radiotherapy and concurrent chemotherapy. Adjuvant chemotherapy consisted of cisplatin (50 mg/m(2)) for six cycles every week. Thirty-three patients received adjuvant radiotherapy by IMRT. Before the IMRT series was initiated, 35 other patients underwent conventional four-field radiotherapy (Box-RT). The two groups did not differ significantly in respect of clinicopathologic and treatment factors.


RESULTS
IMRT provided compatible local tumor control compared with Box-RT. The actuarial 1-year locoregional control for patients in the IMRT and Box-RT groups was 93% and 94%, respectively. IMRT was well tolerated, with significant reduction in acute gastrointestinal (GI) and genitourinary (GU) toxicities compared with the Box-RT group (GI 36 vs. 80%, p = 0.00012; GU 30 vs. 60%, p = 0.022). Furthermore, the IMRT group had lower rates of chronic GI and GU toxicities than the Box-RT patients (GI 6 vs. 34%, p = 0.002; GU 9 vs. 23%, p = 0.231).


CONCLUSIONS
Our results suggest that IMRT significantly improved the tolerance to adjuvant chemoradiotherapy with compatible locoregional control compared with conventional Box-RT. However, longer follow-up and more patients are needed to confirm the benefits of IMRT.
Chen
Miao-Fen
MF
Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan.
Tseng
Chih-Jen
CJ
Tseng
Ching-Cheng
CC
Kuo
Yuen-Chun
YC
Yu
Chun-Yen
CY
Chen
Wen-Cheng
WC
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D011880:Radiotherapy Planning, Computer-Assisted; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery
D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D002945:Cisplatin