Assessment of early toxicity of concomitant radio-chemotherapy in the treatment of locally advanced cervical cancer

Abstract

Introduction

The aim of this paper was to assess early toxicity and feasibility of concomitant radiochemotherapy in the treatment of locally advanced cervical cancer in daily routine clinical practise.

Material and methods

Between 1^st of May 2000 and 15^th of November 2000, twenty one patients suffering from stage IIB and IIIB (FIGO classification) cervical carcinoma were treated in the Radiotherapy Department of the Holycross Cancer Centre by concomitant radio-chemotherapy. Early toxicity of the skin, the lower gastrointestinal system and the genitourinary system was assessed according to acute radiation morbidity scoring criteria EORTC/RTOG. Leukopenia, thrombocytopenia, anemia, nausea, vomiting and nephrotoxicity were scored according to the WHO scale.

Results

There were no treatment-related deaths and no treatment breaks in radiotherapy due to acute toxicity. Only 48% of patients completed all 6 courses of cis-platin. The main causes of withdrawals from consecutive cycles of chemotherapy were: leucopenia - grade 2 or 3, thrombocytopenia - grade 3 and patient refusal. One patient developed acute renal failure. Other adverse effects did not exceed grade 2.

Conclusions

Concomitant radio-chemotherapy in the treatment of locally advanced cervical cancer was feasible and featured acceptable toxicity. Haematologic adverse effects were the main reasons of discontinued chemotherapy. Radiotherapy was well tolerated and all patients completed the whole course.