Concurrent chemotherapy and radiotherapy in invasive cervical cancer patients with high risk factors

The aim of this study was to evaluate the survival of 395 previously untrea ted cervical cancer patients with at least one high risk factor following c oncurrent chemoradiation and to assess the toxicities. Two different chemot herapy regimens were used for concurrent chemoradiation, In the patients wi th squamous cell carcinoma, 100 mg/m(2) of cisplatin was infused intravenou sly, followed immediately by five consecutive daily administrations of 5-fl uorouracil, 1,000 mg/m(2)/day, each infused intravenously over 24 hr, As fo r the patients with adenocarcinoma, 70 mg/m(2) of cisplatin, 250 mg/m(2) of cytoxan and 45 mg/m(2) of adriamycin were administered intravenously on da ys 1, 2, and 3, respectively. The 5-year survival rate was 54.4% with stage III and IV, 62.6% with lymph node metastasis on computed tomogram or MRI, 77.9% with stage I-II disease with lesion size greater than or equal to 4 c m, and 50.3% with small cell carcinoma or adenocarcinoma. Side effects from concurrent chemoradiation such as nausea, vomiting, and alopecia were pres ent in all 395 cases. Anemia, leukopenia, thrombocytopenia, hepatotoxicity, and nephrotoxicity were observed to varying degrees, but there was no toxi c death. This study suggests that cisplatin-based concurrent chemoradiation in treating cervical cancer patients with high risk factors is effective a nd relatively well tolerated, with acceptable toxicity.