Concurrent Cisplatin and 5-Flurouracil Chemotherapy and Radiation Therapy for Locally Advanced Cancer of The Uterine Cervix

Abstract

Objective : The aim of this study was to determine the feasibility and toxicity of concurrent 5-fluorouracil (5-FU), cisplatin (CDDP) and pelvic radiation therapy (RT) in patients with advanced cervical cancer. Methods : We reviewed the charts of 25 patients who underwent concurrent chemoradiotherapy at Dong-A University Hospital from January, 1997 to December 2001 for advanced cervical cancer. Treatment consisted of CDDP, 5-FU and pelvic radiotherapy. CDDP was administered at a dose of 75 mg/m2 before radiotherapy initiation and 5-FU at a dose of 1000 mg/m2 from day two to day five of each course. Radiation was administered to the pelvis in five-day courses at a dose of 1.8 Gy daily every 40 days until a medium dose of 50.4 Gy was reached. The irradiated zone was extended to include paraaortic lymph nodes if necessary. The same schedule was repeated after three weeks. The median number of combined treatment courses per patient was six. Results : Twenty-five patients were enrolled with a median a follow-up of 32 months. CDDP and 5-FU chemotherapy well tolerated. Acute toxicity consisted of grade II to III hematologic toxicity in eleveen patients (44%) and nausea and vomiting is mild, but grade III in only four patients. Late toxicity consisted of grade II cystitis in two patients (8%), grade II proctitis in three patients (12%) and grade IV rectovaginal fistula in two patients (8%). RT was delayed in only 1 patient due to grade III enteritis. The overall response rate was 80% (76% complete, 4% partial). Disease free survival rate and overall survival rate is 68% and 74%. Conclusion : This study shows that Concurrent chemoradiotherapy improves overall survival rates and disease-free survival rates but some increase in acute toxicity. Due to small size sample and short duration of follow up, further study of a large group of patients and the long term survival rate are necessary.