Concurrent chemoradiatherapy with raltitrexed and cisplatin in the treatment of moderate and advanced cervical cancer

Abstract

Objective To investigate the efficacy and safety of concurrent chemoradiatherapy with raltitrexed and cisplatin in treatment of patients with moderate and advanced cervical cancer. Methods From January 2011 to December 2012, a total of 80 patients with moderate and advanced cervical cancer were selected as research subjects and they were randomly assigned to RP group (n=40, received concurrent chemoradiatherapy with raltitrexed and cisplatin treatment) and TP group (n=40, received concurrent chemoradiatherapy with paclitaxel and cisplatin treatment) by envelope method. The chemotherapy regimen of RP group was as follows: raltitrexed 3 mg/m2 intravenous drip 15 min on day 1, and cisplatin 60 mg/m2 intravenous drip 60 min on day 1. The chemotherapy regimen of TP group was as follows: paclitaxel 135 mg/m2 intravenous drip 180 min on day 1, and cisplatin 60 mg/m2 intravenous drip 60 min on day 2. The effective rate, adverse reactions rate, and overall survival (OS) rate and disease free survival (DFS) rate were observed and compared by statistical methods between two groups. This study was approved by the ethics committee of our hospital, and all patients signed the informed consent. Results ①There were no significant differences between two groups in the age, Karnofsky performance status (KPS) score, body weight loss ratio, the maximum diameter of tumor, pathological type, Federation International of Gynecology and Obstetrics (FIGO) stage (P>0.05). ②The effective rates in RP group and TP group were 92.5% (38/40) and 90% (36/40), respectively, and there was no significant difference between them (χ2=0.734, P=0.675). ③The incidences of myelosuppression, rash, alopecia, muscle and joint pain, peripheral neuritis in RP group were 62.5% (25/40), 12.5% (5/40), 30.0% (12/40), 5.0% (2/40), 10.0% (4/40), respectively, and they were significantly lower than those in TP group 82.5% (33/40), 35.0% (14/40), 80.0% (32/40), 25.0% (10/40), 32.5% (13/40), respectively, and all the differences were statistically significant (χ2=4.013, P=0.045; χ2=5.591, P=0.018; χ2=20.202, P 0.05). ④There were no significant differences between two groups in OS curve and DFS curve (χ2=0.930, P=0.330; χ2=0.780, P=0.380). Conclusions Concurrent chemoradiatherapy with raltitrexed and cisplatin in the treatment of moderate and advanced cervical cancer is safe and effective. Its effect is similar to the effect of concurrent chemoradiatherapy with paclitaxel and cisplatin, and resulting in less adverse reactions. Key words: Uterine cervical neoplasms; Radiotherapy; Drug therapy; Raltitrexed; Paclitaxel