Drh. Christie et al., CONCURRENT 5-FLUOROURACIL, MITOMYCIN-C AND IRRADIATION IN LOCALLY ADVANCED CERVIX CANCER, Radiotherapy and oncology, 37(3), 1995, pp. 181-189
Citations number
34
Categorie Soggetti
Oncology,"Radiology,Nuclear Medicine & Medical Imaging
We reviewed 177 patients treated with radical radiotherapy for locally
advanced (FIGO stages IIB, IIIA, IIIB) cervix cancer between January
1979 and December 1989. The radiotherapy was given by external beam tr
eatment to the pelvis and by an intracavitary caesium insertion. Ninet
y-three patients also received chemotherapy which consisted of infusio
nal 5-fluorouracil during the first and last weeks of the external bea
m component of the radiotherapy, combined with bolus mitomycin C (grou
p A, 64 patients) or without mitomycin C (group B, 29 patients). These
groups were compared with patients treated by radiotherapy alone (gro
up C, 84 patients). The median follow-up was 7.2 years. The median sur
vival time for all patients was 47 months, but was significantly highe
r (87 months, p = 0.004) for group A. Rates of relapse-free survival a
nd local control were also higher in group A. Toxicity was assessed in
detail using the Franco-Italian glossary. There was a relatively high
rate of complications, particularly in group A, with 36% of patients
having grade 3 or 4 complications. This increase in toxicity persisted
through all follow-up time intervals. Patients in group B also demons
trated a higher rate of toxicity than group C, but this increase was l
imited to the first 6 months of follow-up. The use of mitomycin C in a
ddition to radiotherapy and 5-fluorouracil should be regarded with cau
tion, as other studies have also shown that toxicity is increased, but
without improvements in survival.