Concurrent chemoradiotherapy using high-dose rate intracavitary brachytherapy for locally advanced cervical cancer (stage III or IVA and pelvic lymph node metastasis)

Abstract

16582 Background: Cisplatin-containing concurrent chemoradiotherapy (CCRT) with brachytherapy is the standard treatment for bulky (above stage II) and pelvic lymph node positive cervical cancer. In this study, we evaluated the efficacy and the feasibility for CCRT using high-dose-rate intracavitary brachytherapy (HDR-ICRT) in the treatment of patients with locally advanced cervical cancer. Methods: A total of 33 patients with stage III or IVa and pelvic lymph node positive cervical cancer treated with CCRT using HDR- ICBT were evaluable. External beam radiotherapy (EBRT) with 45 Gy/25 fractions followed by HDR-ICBT with 28 Gy/8 fractions to point A was performed. Chemotherapy consisted of weekly cisplatin at a dose of 40 mg/m2 for 5 courses was concurrently administered with radiotherapy. Results: There were 25 (75.8%) complete responses and 8 (24.2%) partial responses. The median time to progression was 15.3 months. In the nine recurred patients, local and systemic failure rate was 9.1% and 24.2%, respectively. The 3-year overall survival rate was 59.6%. The incidence of any grade 3/4 acute adverse event was 27.3% and hematologic toxicity was the most common adverse event. There was no grade 3/4 late complications including proctitis and cystitis. Conclusions: Weekly cisplatin 40 mg/m2 concurrent with EBRT followed by HDR-ICBT is feasible and efficacious for patients with locally advanced cervical cancer. No significant financial relationships to disclose.