gms | German Medical Science

Background: Simultanous Radio-Chemotherapy (RCT) is part of treatment in cervical cancer patients, either in primary or adjuvant setting. It is composed of pelvic radiation (homogenous percutanous radiation) and simultanously given chemotherapy (weekly cisplatinum 40mg/m2), in primary treatment completed with braychytherapy of the cervix. We analyzed feasibility due to planned and given doses/cycles of treatment, and outcome of this treatment in an outpatient setting.

Methods: Retrospective analysis of our hospital data base (1/97-9/05) of 121 patients with cervical cancer who underwent primary or postoperative treatment in our hospital.

Results: Seventy-five patients (62%) had combined RCT as part of their treatment. The average age was 49,7 years (28-82) and 80% of patients had performance status ECOG 0. Fourty patients had early cervical cancer, macroscopically limited to the cervix or cervix and vagina upper part (Figo stage IB1-IIA) and 35 patients had bulky or advanced disease (FIGO stage IIB-IVA). Fourty-seven patients (62,7%) underwent surgical treatment and 14 patients (29,8%) were histologically up-staged. Twenty-eight patients (37,3%) had primary RCT. Twenty-three patients were histologically proven lymph-node positive. The median number of given chemotherapy cycles in adjuvant treated patients was 8 (0-14), in primary treated patients6 (0-10). The medain dose of given radiation in adjuvant treated patients for pelvic radiation was 50,4 Gy (39-50,4), for brachytherapy 15 Gy (7-20). In primary treatment the given median dose for pelvic radiation was 50,4 Gy (18-70,2), for brachytherapy 15 Gy (0-20). In 12 patients (16%) we could not give the whole sequence (>75%) of planned therapy due to toxicity of treatment. The overall survival in all patients treated with simultanous RCT was 78,5%.

Conclusion: Primary as well as adjuvant simultanous treatment with Radio-Chemotherapy shows a good feasibility with 95% closeness of therapy for primary and 97% closeness of therapy for adjuvant treatment in an outpatient setting.