Retrospective analysis of concomitant Cisplatin during radiation in patients aged 55 years or older for treatment of advanced cervical cancer: a gynecologic oncology group study.
OBJECTIVE
Patients with stages II to IVa cervical cancer aged 55 years or older were compared with patients younger than 55 years who received weekly cisplatin during pelvic radiation for differences in chemoradiation administration, toxicity, and outcome.


METHODS
Retrospective review included patients enrolled on Gynecologic Oncology Group trial Nos. 120 and 165 (n = 335) who received weekly cisplatin (40 mg/m) during pelvic irradiation (40.8-50.1 Gy) followed by intracavitary brachytherapy (30-40 Gy).


RESULTS
For all 335 patients, 53% completed 6 cycles of chemotherapy during radiation with no observed difference in frequency among patients younger than 55 years or 55 years or older (P = 0.616). Excess hematological but not genitourinary toxicity was seen in patients 55 years or older. At 5 years, 56% of patients younger than 55 years were predicted to be alive and disease-free compared with 55% of those aged 55 years or older (P = 0.629). A 5-year survival was 60% in patients younger than 55 years as compared with 56% in patients aged 55 years or older (P = 0.265).


CONCLUSIONS
Patients aged 55 years or older with locally advanced cervical cancer undergoing concurrent weekly cisplatin with pelvic radiation on cooperative group clinical trials achieve similar progression-free and overall survivals as younger patients. Disparity was not observed in the seriousness or frequency of treatment-related sequelae.
Kunos
Charles
C
Department of Radiation Oncology, Case Comprehensive Cancer Center and University Hospitals of Cleveland Case Medical Center, Cleveland, Ohio, USA. charles.kunos@uhhospitals.org
Tian
Chunqiao
C
Waggoner
Steven
S
Rose
Peter G
PG
Lanciano
Rachelle
R
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001918:Brachytherapy; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
D000970:Antineoplastic Agents; D002945:Cisplatin