Concurrent Chemoradiotherapy without Brachytherapy in Locally Advanced Cervical Cancer

AUTHORS

Sima Kadkhodayan 1 , Fateme Homaee Shandiz 2 , * , Mehdi Seilanian Toussi 2 , Monavar Afzal Aghaee 3 , Farnoosh Farshidi 4 , Parvane Dehghan 5

1 Women’s Health Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Solid Tumor Treatment Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

3 Dept. of Epidemiology, Mashhad University of Medical Sciences, Mashhad, Iran

4 Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

5 Dept. of Radiation Oncology, Mashhad University of Medical Sciences, Mashhad, Iran

How to Cite: Kadkhodayan S, Homaee Shandiz F, Seilanian Toussi M, Afzal Aghaee M, Farshidi F, et al. Concurrent Chemoradiotherapy without Brachytherapy in Locally Advanced Cervical Cancer, Int J Cancer Manag. 2013 ; 6(4):e80468.

ARTICLE INFORMATION

International Journal of Cancer Management: 6 (4); e80468
Published Online: December 30, 2013
Article Type: Research Article
Received: June 30, 2013
Accepted: September 03, 2013

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Abstract

Background: Concurrent chemoradiotherapy (EBRT + cisplatin) plus intracavitary brachytherapy is the standard of care in patients with advanced cervical cancer. However, a number of patients could not undergone brachytherapy due to massive residual tumor or anatomical distortion. In this study, we have evaluated the treatment outcome in patients with locally advanced cervical cancer, undergone conventional EBRT plus cisplatin based chemotherapy.

Methods: In this study, we have selected patients with locally advanced cervical carcinoma (stage: IIB to IIIB) undergone external beam radiotherapy and chemotherapy without brachytherapy at our institute between October of 2007 and October of 2009. The patients have received 50 Gy within 5 weeks to whole pelvic that has followed by a localized boost dose on tumor to 70 Gy concurrently with cisplatin 35 mg/m2 weekly. The treatment has related toxicities, and survival (overall and disease free) have evaluated.

Results: 30 cases with a median age of 55 (range; 40 to 73) have been studied. According to FIGO classification, the clinical stages were as follows: stage: IIB 23, IIIA 4, and IIIB 3 cases. Three months after treatment, 19 patients (63.3%) have achieved complete response. With a median follow up time of 18 months (range; 10-33 months), 8/23 cases (34.7%) with stage IIB and 2/7 (28.5%) among stage IIIA-IIIB remained disease free at the end of follow up. Data have shown a 2- year overall survival rate of 58.7% ± 9% and 2- year disease free survival of 37.7% ± 9% . Most toxicities were grade I and II. 2 (6.6%) grade III diarrhea and 4 (13.3%) grade III neutropenia have recorded.

Conclusion: Although a considerable number of patients have achieved complete response using concurrent chemoradiotherapy without brachytherapy, the overall treatment outcomes especially for stage IIIA-IIIB were unsatisfactory. Using modern radiation therapy techniques with increased delivered boost dose could improve treatment results.

Keywords

Cervical cancer Radiotherapy Concurrent chemoradiotherapy

© 2013, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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