Efficacy and Safety of Concurrent Chemoradiation as Adjuvant Therapy after Radical Surgery in High-Risk Early-Stage Carcinoma of the Uterine Cervix

Abstract

Objectives : To evaluate the efficacy and safety of concurrent chemoradiation (CCRT) in the treatment of high-risk, early-stage cervical carcinoma after radical surgery. Methods : Patients with clinical stage of IB and IIA cervical carcinoma, initially treated with radical hysterectomy and pelvic lymphadenectomy, and who had positive pelvic nodes and/or positive resection margins and/or parametrial involvement were eligible for this study. All patients received 50.4 Gy external pelvic radiation in 28 fractions. Chemotherapy consisted of cisplatin (x1) and 5-FU (x5) every 3 weeks, with the first and second cycles given concurrent to with radiation. The toxicities of the treatment were evaluated and graded by WHO criteria. Results : Between 1999 and 2003, 25 patients were entered onto the study. During the follow-up period ranging from 5 to 49 months (median: 26.0 months), the 2-year progression-free survival (PFS) and overall survival (OS) were 87.7% and 95.8%, respectively. Leukopenia, neutropenia, and nausea/vomiting were most common and concerned toxicities. The toxicities above grade 3 were observed in 12 cycles (16.9%) in leucopenia, five cases (7.0%) in neutropenia, and 13 cases (18.3%) in nausea/vomiting. But no treatment-related deaths occurred. Conclusion : CCRT as adjuvant therapy seems to be effective and well-tolerable method of treating patients with high-risk factors after radical surgery in cervical carcinoma.