Treatment of carcinoma of the uterine cervix with concomitant cisplatin, 5-fluorouracil and split course hyperfractionated radiotherapy

• Published in: European journal of obstetrics & gynecology and reproductive biology 1998-03, Vol.77 (1), p.95-100
• Main Authors: Tubiana-Mathieu, N, Bonnier, P, Delaby, F, Murraciole, X, Lejeune, C, Hadjadj, D.J, Juin, P, Piana, L
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antimetabolites, Antineoplastic - administration & dosage; Antimetabolites, Antineoplastic - adverse effects; Antimetabolites, Antineoplastic - therapeutic use; Antineoplastic agents; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Brachytherapy; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - radiotherapy; Chemotherapy; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Cisplatin - adverse effects; Cisplatin - therapeutic use; Combined treatments (chemotherapy of immunotherapy associated with an other treatment); Disease-Free Survival; Female; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Fluorouracil - therapeutic use; Humans; Medical sciences; Middle Aged; Neoplasm Staging; Pharmacology. Drug treatments; Primary cancer of uterine cervix; Radiation-Sensitizing Agents - administration & dosage; Radiation-Sensitizing Agents - adverse effects; Radiation-Sensitizing Agents - therapeutic use; Radiotherapy, Adjuvant; Split course hyperfractionated radiotherapy; Survival Analysis; Time Factors; Uterine Neoplasms - drug therapy; Uterine Neoplasms - mortality; Uterine Neoplasms - radiotherapy
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(97)00239-X

To improve local and systemic control of bulky (>4 cm) and/or advanced primary cancer of the uterine cervix, 35 patients were treated with concomitant cisplatin (CDDP), 5-fluorouracil (5-FU) and split course hyperfractionated radiotherapy. Radiation was administered to the pelvis in five-day courses at a dose of 1.5 Gy twice daily every 21 days until a median dose of 45 Gy was reached. 15 Gy more were administered to involved parametrium or central tumor by external radiotherapy or brachytherapy. The irradiated zone was extended to include paraaortic lymph nodes if necessary. CDDP was administered at a dose of 20 mg m −2 and 5 FU at a dose of 500 mg m −2 from day one to day five of each course. The median number of combined treatment courses per patient was four (1–6). Local responses were obtained in 19 out of 24 patients in whom evaluation was feasible (i.e. who did not undergo surgery prior to combined therapy). Median survival was not attained with a median follow up of 33 months, three year overall survival was 62% and 52% in patients with local control and in the whole population respectively. Several patients with stage III and IV tumors achieved a very long survival. Acute toxicity was manageable but three patients required surgical repair of late radiation complications. This combined chemotherapy and radiotherapy resulted in good local control and did not rule out surgery.