Young Seok Kim MD, PRESENTER: Nothing to Disclose

Abstract:Purpose/Objective: A prospective randomized trial was performed to assess acute toxicities, response and survival difference between monthly 5-FU plus cisplatin (FP) and weekly cisplatin in concurrent chemoradiotherapy for locally advanced cervical cancer. Materials/Methods: From March 1998 to December 2001, 66 patients were enrolled in this study. Patients were assigned randomly to monthly FP (group I) or weekly cisplatin (group II). The patients of group I received FP (5-FU 1,000 mg/m2/day + cisplatin 20 mg/m2/day, IV continuous infusion, for 5 days, and 3 cycles with a 4 weeks interval) and those of group II received cisplatin (cisplatin 30 mg/m2/day, IV bolus, for 1 day, and 6 cycles with 1 week interval) with radiotherapy. Radiation therapy consisted of external beam irradiation of 41.4-50.4 Gy in 23-28 fractions and high dose rate brachytherapy delivering a total dose of 30-35 Gy in 6-7 fractions. During brachytherapy, a parametrial boost was delivered. The median follow-up period for survivors was 32 months. Results: The FIGO stage distributions of groups I (n=37) and II (n=29) were as follows; IIB 23, IIIA 3, IIIB 10, and IVA 1 in group I, and 23, 0, 4, and 2 in group II, respectively. The compliances of the groups were 60% and 83%, respectively (p=0.04). During the radiation therapy, the incidences of hematologic toxicity more than grade 2 were 35%, and 17%, respectively, and only one patient experienced grade 3 gastrointestinal toxicity in group I. No patient was observed with severe genitourinary toxicity. The complete response rates at 3 months after radiation therapy were 96% and 88%, 4-year overall survival rates 64% and 69%, and the 4-year disease free survival rates were 56% and 51%, respectively. Conclusions: No significant difference was observed in the toxicities, responses to treatment, or survival rates of patients receiving monthly FP or weekly cisplatin. However, patients that received weekly cisplatin showed better compliance.

Kim MD, Y, Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3239824.html