Pelvic radiation with cisplatin-based chemotherapy and radiotherapy for locally advanced cervical ut
Actualizado: 27 sept 2020
Pelvic radiation with cisplatin-based chemotherapy and radiotherapy for locally advanced cervical uterine cancer.
H. R. Castro, L. Salazar, Radiotherapy and Medical Oncology Group; Instituto Nacional de Cancer de Guatemala, Guatemala, Guatemala; Grupo Medico Angeles, Guatemala, Guatemala
Background: We compared the effect of radiotherapy and cisplatin-based chemotherapy in women with high-risk cervical cancer; we performed a randomized trial of pelvic radiation with two chemotherapy regimens – concurrent cisplatin alone; and concomitant neo-adjuvant cisplatin and cyclophosphamide.
Methods: Between 2005 and 2009, 140 women with advanced cervical cancer confined to the pelvis (stages IIB and III), were randomly assigned to receive either 50 Gy of radiation to the pelvis (group 1), received 40 mg/m2 of cisplatin per week for five weeks (group 2) and received 75 mg/m2 of cisplatin on day 1, and 400 mg/m2 of cyclophosphamide on day 1, every 28 days per four six concomitant neoadjuvant with radiotherapy (group 3). Patients were then to receive one or two applications of low-dose-rate intracavitary radiation.
Results: The analysis included 101 women. The median duration of followed was 24 months. Both groups that received cisplatin had a higher rate of progression-free survival than the group that received radiotherapy alone was P: 0.022 (95 percent confidence interval, 0.026 to 0.032; 21,31 vs. 17,47 mounts ). The relative risks of progression of disease or death were 0.57 (95 percent confidence interval, 0.40 to 0.75) in group 2, as compared with group 3. The overall survival rate was significantly higher in groups 2 and 3 than in group 1, with relative risk of death of 0.032 (95 percent confidence interval, 0.28 to 0.35; 31.7 mounts group 1, not yet reach the median overall survival in group 2 and 3).
Conclusions: Regimens of radiotherapy and chemotherapy that contain cisplatin improve the rates of survival and progression-free survival among women with locally advanced cervical cancer.