Radiotherapy versus radiochemotherapy with cisplatin in treatment of cervical cancer.
OBJECTIVE
To compare effects of concomitant radiochemotherapy (RCTh) and radiotherapy (RTh) alone in patients with cervical carcinoma and with 36-months follow-up analysis.


METHODS
106 stage IIA-IVA cervical carcinoma women were divided in two groups. RCTh group was treated with teleradiotherapy (50.4 Gy/T), intracavitary brachytherapy (46 Gy), and iv cisplatin (40 mg/m(2)). RTh group was treated with pelvic teletherapy (52-54 Gy/T) and intracavitary brachytherapy (50-55 Gy).


RESULTS
In RCTh group absorbed radiation dose was significantly lower (50.4 vs. 52.7 Gy) and the duration of treatment was significantly shorter (45.1 days vs. 47.8 days). There were no statistical differences in both groups in survival (59% in RCTh group vs. 56% in RTh group), response to treatment (86% vs. 90%), local recurrence (42% vs. 49%) metastasis occurrence (21% vs. 17%), anemia (40% vs. 26%), early postradiation reactions in intestines (77% vs. 65%) and bladder (71% vs. 61%) as well as in incidence of rectovaginal (10% vs. 4%) and vesicovaginal formation of fistulas (6% vs. 4%), respectively. There were significant differences between two groups in: nausea (77% vs. 6%), vomiting (65% vs. 3.7%), leucopenia (69% vs. 26%) and thrombocytopenia (35% vs. 9%), and late postradiation bladder effects (94% vs. 74%). RCTh patients with anemia had lower 36-months survival rates (42% vs. 71%), more frequent local recurrences (77% vs. 31%) and metastasis-free survival rates (61% vs. 90%) than RCTh patients without anemia.


CONCLUSIONS
RCTh gives better treatment results in patients without than in patients with anemia and higher overall survival rates than RTh in patients without anemia. The only clinical prognostic factor for advance cervical carcinoma is the clinical stage of the disease.
Torbé
Bogdan
B
Department of Radiotherapy, Pomeranian Medical University, Szczecin, Poland.
Falco
Michał
M
Torbé
Andrzej
A
Ciepiela
Przemysław
P
Kurzawa
Rafał
R
D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology; D001918:Brachytherapy; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
D011838:Radiation-Sensitizing Agents; D002945:Cisplatin