title: Treatment interruption during concurrent chemoradiotherapy of uterine cervical cancer; analysis of factors and outcomes.
abstract: BACKGROUND
  To evaluate factors which effect treatment interruption during concurrent chemoradiotherapy (CCRT) and overall survival in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital.
  
  
  METHODS
  Between January 2006 and December 2007, 107 patients with stage IB2-IVA as FIGO staging, 2000, were treated with CCRT in Srinagarind Hospital. Factors which caused treatment interruptions and impacted on overall survival were reviewed and analyzed.
  
  
  RESULTS
  Twenty of 107 patients had treatment interruption during CCRT in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. The causes of treatment interruption were as follows: hematologic toxicity was found in 16 of 20 cases, 12 cases with grade 2 and 4 cases with grade 3; three of 20 cases had gastrointestinal toxicities, 1 case with grade 2 and 2 cases with grade 3; one case had grade 3 skin toxicity. The mean total treatment time of the uninterrupted and interrupted groups were significantly different (78.98 days vs 161.80 days, p <0.001). The patients who could tolerate ≥5 cycles of cisplatin administration had significantly higher mean white blood counts (WBC) (9,769 cells/ mm3 vs 7,141 cells/mm3, p=0.02). The mean initial hemoglobin (Hb) in the uninterrupted group was significantly higher than the interrupted group (11.5 mg% vs 10.3 mg%, p=0.03). Other factors including age, KPS, initial platelets, initial serum creatinine levels showed no statistical significance. The 3-year overall survival of the uninterrupted group was better than in the interrupted group (78.6% vs 55.0%, p=0.03).
  
  
  CONCLUSIONS
  The initial Hb and WBC levels were significantly correlated with treatment interruption during CCRT in patients with uterine cervical cancer. The 3-year overall survival of the uninterrupted group was significantly better than interrupted group. These factors may then be used indirectly to predict the outcomes of treatment.
authors: Department of Radiology, Faculty of Medicine, Khon Kaen University,Thailand E-mail : pmonti@kku.ac.th.
authors: Srichai
authors: S
authors: Krusun
authors: Montien
authors: M
authors: Pesee
authors: Narudom
authors: N
authors: Supakalin
authors: Komsan
authors: K
authors: Thamronganantasakul
authors: Chunsri
authors: C
authors: Supaadirek
authors: Prawat
authors: P
authors: Padoongcharoen
mesh_terms: D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000166:cytology; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003401:Creatine / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007958:Leukocyte Count; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D028761:Withholding Treatment
chemical_list: D006454:Hemoglobins; D003401:Creatine; D002945:Cisplatin