title: Weekly Cisplatin and Volumetric-Modulated Arc Therapy With Simultaneous Integrated Boost for Radical Treatment of Advanced Cervical Cancer in Elderly Patients: Feasibility and Clinical Preliminary Results.
abstract: To evaluate the feasibility and clinical preliminary results of weekly cisplatin and volumetric-modulated arc therapy to the pelvis with simultaneous integrated boost to macroscopic disease in a cohort of elderly patients.
  
  
  
  Inclusion criteria of this prospective study were age ≥70 years, Karnofsky performance status 70 to 100, locally advanced histologically proven squamous cervical carcinoma, and patients unable to undergo brachytherapy. Radiation doses prescribed were 66 Gy to the macroscopic disease and 54 Gy to the pelvic nodes in 30 fractions. Weekly cisplatin dose was 40 mg/mq.
  
  
  
  A total of 30 patients were recruited. Median follow-up was 32 months (range: 8-48 months). Median age was 72 years (range: 70-84 years). The 3-year overall survival and local control were 93% and 80%, respectively. The median time to progression was 24 months (range: 6-30 months). Analyzing clinical outcome grouping based on the stage of disease, II versus III, the 3-year overall survival was 100% and 85%, respectively. The 3-year local control was 91% for stage II and 67% for stage III. Acute and late toxicities were acceptable without severe events.
  
  
  
  Weekly cisplatin and volumetric-modulated arc therapy-simultaneous integrated boost for radical treatment of advanced cervical cancer in the current cohort of elderly patients were feasible. Long-term results and prospective randomized trials are advocated.
authors.affiliation: 1 Radiation Oncology, Sacro Cuore Don Calabria-Cancer Care Center, Negrar, Verona, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Mazzola
authors.affiliation: 1 Radiation Oncology, Sacro Cuore Don Calabria-Cancer Care Center, Negrar, Verona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricchetti
authors.affiliation: 1 Radiation Oncology, Sacro Cuore Don Calabria-Cancer Care Center, Negrar, Verona, Italy.
authors.forename: Alba
authors.initials: A
authors.lastname: Fiorentino
authors.affiliation: 1 Radiation Oncology, Sacro Cuore Don Calabria-Cancer Care Center, Negrar, Verona, Italy.
authors.forename: Niccolò Giaj
authors.initials: NG
authors.lastname: Levra
authors.affiliation: 1 Radiation Oncology, Sacro Cuore Don Calabria-Cancer Care Center, Negrar, Verona, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Fersino
authors.affiliation: 2 Statistic Sciences Faculty, University of Palermo, Palermo, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Di Paola
authors.affiliation: 1 Radiation Oncology, Sacro Cuore Don Calabria-Cancer Care Center, Negrar, Verona, Italy.
authors.forename: Ruggero
authors.initials: R
authors.lastname: Ruggieri
authors.affiliation: 1 Radiation Oncology, Sacro Cuore Don Calabria-Cancer Care Center, Negrar, Verona, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D002945:Cisplatin
keywords: VMAT; advanced cervical cancer; elderly patients; gynecological malignancies