Extended field intensity-modulated radiotherapy plus concurrent nedaplatin treatment in cervical cancer

Liu,Yunqin; Yu,Jinming; Qian,Liting; Zhang,Hongyan; Ma,Jun

doi:10.3892/ol.2016.4416

Extended field intensity-modulated radiotherapy plus concurrent nedaplatin treatment in cervical cancer

Authors:
- Yunqin Liu
- Jinming Yu
- Liting Qian
- Hongyan Zhang
- Jun Ma
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Affiliations: Department of Radiation Oncology, Shandong Tumor Hospital, Shandong Medical University, Jinan, Shandong 250117, P.R. China, Department of Radiation Oncology, Anhui Cancer Hospital, Anhui Medical University, Hefei, Anhui 230001, P.R. China
Published online on: April 6, 2016 https://doi.org/10.3892/ol.2016.4416
Pages: 3421-3427

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Abstract

The present study assessed the efficacy and toxicity of definitive extended-field intensity-modulated radiotherapy (EF-IMRT) plus concurrent chemotherapy in cervical cancer. A total of 48 patients with cervical cancer received the planning target volume between 39.6 and 50.4 Gy in 1.8‑2.0 Gy daily fractions, while the enlarged pelvic and/or para‑aortic nodes were treated with a total dose of 55‑60 Gy in 2.0‑2.4 Gy daily fractions using simultaneous integrated boost‑IMRT. All patients underwent high dose‑rate brachytherapy. Concurrent to EF‑IMRT, nedaplatin was administered weekly at a median dose of 30 mg/m2 (range, 25‑40 mg/m2) for 5 weeks with a total of 150 mg/m2. Of the 48 patients, 46 patients exhibited initial complete responses and 2 patients had partial responses, with a response rate of 100%. After 4‑24 months of treatment, 12 patients (27.08%) had local and/or distant failure and 39 patients (81.25%) were alive at the last follow‑up. The 12-month overall survival (OS) and disease‑free survival (DFS) were 87.5 and 75.8%, respectively, while the 24‑month OS and DFS were 69.7 and 49.7%, respectively. Grade ≥3 acute neutropenia and thrombcytopenia occurred in 20 (41.7%) and 4 (8.3%) patients, respectively, while 2 patients (4.2%) developed grade ≥3 diarrhea and 2 (4.2%) had grade ≥3 late toxicities. However, no patients exhibited grade ≥3 vomiting. Thus, concurrent nedaplatin chemotherapy with definitive EF‑IMRT was effective and relatively safe for treating patients with cervical cancer. Furthermore, EF-IMRT was able to deliver ≤60 Gy to enlarged para-aortic and/or pelvic nodes using simultaneous integrated boost without increased acute and late gastrointestinal toxicity.

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