Radiochemotherapy versus chemotherapy in locally advanced cervix cancer: A pilot study.

Abstract

e15561 Background: Many reports have correlated 1) hypoxia with attenuated responses to radiotherapy and 2) a good oxygenation as function of high HGB level in the peripheral blood. There is agreement to increase to the response to the radiotherapy of head and neck with the use of erythropoietin to increase the hemoglobin level. Methods: From January 2002 until January 2009 we treated 88 patients with cervix locally advanced, 26 patients in stage IIB, 28 in stage IIIA 20 in stage III B and 14 patients in IV stage. 44 patients previously treated with chemotherapy (cisplatin, ifosfamide, paclitaxel), the response of chemotherapy was 12 PR,7NC,3 PD. All patients had an HGB between 9 and 12 gr/dL and from 2 weeks before radiotherapy we daily treated with erythropoietin 10,000 UI to increase HGB between 13 and 14 gr/dL, then we gave erythropoietin every day with radiotherapy. In the second group 44 patients were treated with radiotherapy plus 5FU 1g/sm/day, days 1-5, continuous iv infusion + carboplatino 80 mg and erythropoietin. Results: We have analyzed the patients one month after radiotherapy we valued the result of the treatment. Only in 28 /44 patients we used to increase the HGB to 13-14 gr, in the other 8 patients (37% ) the value of HGB was between 9-11 gr. The response to radiotherapy was 26 PR, 16 NC and 2 PD. The response of the second treatment was 15 CR,7 PR. In 8/44 we used to interrupt treatment for III grade of leuko-thrombocytopenia. Conclusions: In patients, previously treated with chemotherapy, the residual disease is probably hypoxic and therefore is radio-resistant for this reason does not increase the efficacy of radiotherapy nonstante the value of HGB between 13-14 gr, after chemotherapy we had a compromised bone marrow hence we coclude that it is difficult to increase the value of hgb after chemotherapy for bone marrow failure. We are continuing the radiotherapy in concomitant with 5FU plus carboplatin and erytropoeitin in the first choice of treatment of cervix cancer locally advanced seeing the good response 30/44 patients with complete response and 14 /44 partial response No significant financial relationships to disclose.