73. Concurrent weekly cisplatin and radiotherapy in cervical cancer patients. A report on acute toxicity

Abstract

Material and method

Between May 1999 and January 2001, 41 consecutive cervical cancer patients (pts), median age 46 yrs (range 29–68), were treated with concurrent cisplatin and pelvic irradiation with curative intent (29 pts FIGO stage IB “bulky”, IIB–IVA) or postoperatively (11 pts who had positive pelvic lymph nodes and/or involvement of the surgical margin and/or large and deeply invasive lesion). Adequate bone marrow function and normal serum creatinine were required. Cisplatin given as a 60-minute infusion, was administered weekly at the dose of 40 mg/sqm (max. 70 mg) for six cycles. Antiemetic therapy was routinely given. Three patients received irradiation on out-patient basis.

Results

A total of 145 cycles were administered. The median number of cisplatin cycles was 4 (range: 1–6). Overall, 65% of pts received at least four cycles of cisplatin. The reasons for chemotherapy discontinuation included low level of creatinine clearence (2 pts), worsening of performance status (3 pts), and myoclonia after cisplatin injection (1 pt). Moderate emesis occurred in one patient, grade 2 leukopenia in two other cases. There were no severe acute effects precluding the delivery of planned radiotherapy. At present six patients are still on therapy.

Conclusion

Pelvic radiotherapy combined with weekly cisplatin is feasible in a routine practice. This modality is also suitable for patients treated on out-patient basis.