Cisplatin Concurrent Radiotherapy Research Articles

Phase II Clinical Study of Nab-paclitaxel Combined with Cisplatin Concurrent Radiotherapy in the Treatment of Advanced Cervical Cancer

Phase II Clinical Study of Nab-paclitaxel Combined with Cisplatin Concurrent Radiotherapy in the Treatment of Advanced Cervical Cancer

Three Weekly Versus Weekly Cisplatin Concurrent Radiotherapy in Patients with Post-operation Cervical Cancer: A Retrospective Analysis

To evaluate completion rate and acute treatment-related toxicity of concurrent chemoradiotherapy with cisplatin 40 mg/m2 for one day per week compared to cisplatin 20 mg/m2 for consecutive five days every three weeks in postoperative radiotherapy for cervical cancer. This retrospective study included 59 patients, with postoperative pathology suggesting cervical malignant tumors, FIGO stage IB-IIA, undergoing radiotherapy and concurrent chemotherapy between January 2013 and December 2017. All patients were divided into two groups, weekly group and triweekly group. Patients of weekly group received weekly cisplatin at a dose of 40 mg/m2 for at least 4 to 5 cycles and patients of triweekly group received 20 mg/m2 cisplatin for five days every three weeks for at least 1 or 2 cycles. All patients received concurrent chemotherapy at the beginning of radiotherapy. Main outcome measures included clinical completion rate and acute treatment-related toxicity. The proportion of patients who completed 4 or 5 cycles chemotherapy in weekly group was 66.7%(20/30), and that completed 1 or 2 cycles chemotherapy in triweekly group was 100%(29/29, P＜0.05). Grade 1-2 acute hematological toxicities were similar in the two groups, as follows: grade 1-2 leukopenia (66.7% vs. 51.7%, p＞0.05), grade 1-2 thrombocytopenia (10% and 13.7%, p＞0.05), and grade 1-2 anemia (43.3% and 20.6%, p＞0.05). Most patients in weekly group have no significant gastrointestinal toxicity, while, in triweekly group, 65.5% patients have grade 1-2 nausea or vomiting( p＜0.05), with no grade 3-4 gastrointestinal toxicity. Only 3.3% of weekly group were found having grade 1 hepatotoxicity, and only 3.4% of triweekly group were found having grade 1 nephrotoxicity. No treatment related deaths were encountered. This retrospective study appears to show concurrent chemoradiotherapy with triweekly 20mg/m2 cisplatin for consecutive five days in post-operation cervical cancer gives better completion rate with similar Grade 1-2 acute hematological toxicities, hepatotoxicity, and nephrotoxicity. In addition, the main reason that part of patients in triweekly group did not complete the whole chemotherapy courses was hematological toxicities after the first cycle chemotherapy. Nevertheless, the cumulative hematological toxicity of weekly cisplatin 40 mg/m2 was not lower than that of three weekly 20 mg/m2 because of the high frequency of chemotherapy. Due to the reduction of the frequency of chemotherapy, the time of hospitalization and the simplification of hospitalization procedures, the better compliance, and quality of life of three weekly patients are in line with the situation of the shortage of medical resources in China. We will continue to follow up these patients to assess late treatment related toxicity and long term treatment outcomes.

Clinical effect of paclitaxel and cisplatin concurrent radiotherapy and chemotherapy for advanced cervical cancer

Objective To investigate the clinical efficacy of simultaneous release of paclitaxel and cisplatin chemotherapy in treatment advanced cervical cancer.Methods 90 patients with advanced cervical cancer were randomly divided into control and experimental group,the experimental group was treated with paclitaxel and cisplatin concurrent radiotherapy and chemotherapy treatment,the control group was treated with 5-Fu,bleomycin and cisplatin for treatment.Results The clinical effective rate was 84.5％,which was higher than that of the control group (65.0％) ( P ＜ 0.05 ) ; experimental group of patients whose bone marrow suppression and gastrointestinal disorders as well as opportunities arise severity were higher( P ＜ 0.05 ) ; two groups of patients the clinical side effects appear no significant differences in case-times( P ＞ 0.05 ).Conclusion The use of paclitaxel in advanced cervical cancer and cisplatin in patients with concurrent radiotherapy and chemotherapy treatment,which could effectively improve patient outcomes,improve patient survival. Key words: Paclitaxel; Cisplatin ; Cervical neoplasms; Radiotherapy

Gefitinib, cisplatin, and concurrent radiotherapy for locally advanced head and neck cancer: EGFR FISH, protein expression, and mutational status are not predictive biomarkers

Gefitinib was demonstrated to be synergistic with cisplatin and radiotherapy (RT) in in vitro studies. Biomarkers predictive of response to gefitinib in squamous cell head and neck cancer is still lacking. Thirty-one patients with locally advanced and easily accessible primary tumor sites for biopsies were recruited. Gefitinib was started 3 weeks before the start of cisplatin/concurrent radiotherapy (CTRT) and continued during the CTRT phase and thereafter for 4 months as consolidation phase. Two baselines and a repeat tumor sample were taken after 2 weeks of gefitinib alone to study its impact on tumor gene expression. Epidermal growth factor receptor (EGFR) protein expression, FISH and mutational status, and matrix metallopeptidase 11 (MMP11) protein expression were correlated with response and survival outcome. The overall response rate to gefitinib alone was 9.7%. The survival outcome is as follows: median disease free 1.3 years, median survival time 2.4 years, 3-year disease free 42.9%, and 3-year overall survival 48.4%. EGFR FISH, protein expression, and mutational status did not predict for response nor survival outcome of patients. Although MMP11 overexpression did not predict for response, it predicted significantly for a poorer survival outcome. Gefitinib can be combined safely with cisplatin/RT. More studies are needed to uncover predictive biomarkers of benefit to gefitinib.