Toxicities and response of concurrent chemoradiotherapy for stage IIB-IIIB cervical cancer.

Abstract

e15549 Background: Cervical cancer is the most common cancer in women in Vietnam. Concurrent chemoradiotherapy (CCRT) has been proved survival benefit and emerged as the standard treatment of locally advanced cervical cancer. However, it significantly increases early toxicities. This study evaluated the acute toxicities and responses of CCRT in treatment of stage IIB-IIIB cervical cancer in Vietnam. Methods: From November 2006 to December 2007, 60 patients with stage IIB-IIIB cervical cancer were treated by CCRT. EBRT consisted of 40 Gy/20 fractions, followed by 10 Gy boost to the parametrium and intracavitary HDR brachytherapy 7 Gy to point A/fraction/week in 3 fractions. Chemotherapy with cisplatin 40 mg/m2/weekly for 6 cycles started by the first day of EBRT. Results: All the patients completed treatment protocol. Grade 3-4 leukopenia, neutropenia, and thrombocytopenia were 40%, 33.3%, 8.3% respectively. 19 cases (31.7%) had renal toxicity (grade 1: 16 cases, grade 2: 2 cases, and grade 3: 1 case). Grade 3-4 toxicities increased sharply after the fourth cycle of chemotherapy. Mean overall treatment time is 72 days. 15 patients (25%) had to delay treatment mainly due to hematologic toxicity (10/15 cases). The overall response rate was 96.7% (complete response: 81.7%; partial response: 15%). Conclusions: CCRT is relatively high hematologic toxicities and high response rate. This study pointed out the relationship between the risk of toxicities and number of chemotherapy cycles. CCRT with 5 cycles of chemotherapy would decrease toxicities and overall treatment time. No significant financial relationships to disclose.