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Comparison of two different chemotherapy regimens for concurrent chemoradiotherapy in stage Ⅰb2 to Ⅳ a squamous cell carcinoma of the uterine cervix

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Author:
No author available
Journal Title:
Chinese Journal of Obstetrics and Gynecology
Issue:
10
DOI:
10.3760/cma.j.issn.0529-567x.2013.10.010
Key Word:
宫颈肿瘤;癌,鳞状细胞;放射疗法,调强适形;药物疗法;肿瘤治疗方案;Uterine cervical neoplasms;Carcinoma,squamous cell;Radiotherapy,intensity-modulated;Drug therapy;Antineoplastic protocols

Abstract: Objective To compare the clinical efficacy and safety of two chemotherapy regimens for concurrent chemoradiotherapy in patients with stage Ⅰ b2 to Ⅳ a squamous cell carcinoma of the uterine cervix.Methods Between November 2007 and November 2011,146 patients with stage Ⅰ b2 to Ⅳ a squamous cell carcinoma of the uterine cervix who received concurrent chemoradiotherapy in Peking University Cancer Hospital were analyzed.All cases were divided into two groups according to the different chemotherapy regimens during radiation therapy,the group receiving radiotherapy concomitant with weekly cisplatin or nedaplatin alone (platinum alone group,n =59),the group receiving radiotherapy concomitant with cisplatin plus fluorouracil or nedaplatin plus tegafur every 3 weeks (combined group,n =87).There were no statistical difference in the clinical and pathological characteristics between the two groups.Results Patients were evaluated by pelvic examination and pelvic MRI after chemoradiotherapy for 3 months according to WHO criteria.The response rate were respectively 97% (57/59) and 93% (81/87) in platinum alone group and combined group,in which there was no significant difference (P =0.249).The five-year overall survival and the five-year progression-free survival of platinum alone group and combined group were respectively 61.2% versus 69.5% (P > 0.05) and 43.3% versus 24.4% (P > 0.05).There were also no statistically significant differences between platinum alone group and combined group in the five-year local recurrence rate and five-year distant metastasis (11.8% versus 9.8%,29.4% versus 38.7% ; all P > 0.05).Acute gastrointestinal toxicities (nausea and vomiting) in combined group were exactly higher than that in the other group [78% (68/87) versus 51% (30/59),P <0.01].Moreover,anaemia was slightly more common in combined group [53% (46/87) versus 25% (15/59),P =0.019].However,the occurrence rate of the acute or late proctitis and cystitis did not reveal difference between two groups (P > 0.05).Conclusions Both concurrent chemoradiotherapy regimens had similar efficacy on cervical cancer patients with stage Ⅰ b2 to Ⅳa.But the toxicity was lower in patients with weekly platinum than those with platinum-based combined regimens during radiation therapy.

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