Incidence and temporal pattern of anorexia, diarrhea, weight loss,and leukopenia in patients with cervical cancer treated with concurrent radiation therapy and weekly cisplatin:comparison with radiation therapy alone

AbstractObjective: To investigate the temporal patterns of anorexia, diarrhea,weight loss, and leukopenia in chemoradiation therapy (CRT) for cervicalcancer compared with radiation therapy (RT) alone.Methods: Thirty-eight patients receiving RT alone and 30 patientsreceiving CRT were studied. Patients were treated with a combination ofexternal beam irradiation and high-dose rate intracavitary irradiation. Cisplatin was given once a week for five weeks concurrently with theexternal beam irradiation. CRT was divided into low-dose CRT group(cisplatin, 20-30 mg/m2, n=16) and high-dose CRT group (cisplatin, 35-40mg/m2, n=14). Toxicities were evaluated before, every week up to 7weeks during the cycle, and 12 weeks after initial irradiation,according to the National Cancer Institute Common Toxicity Criteria.Results: In the high-dose CRT group, anorexia during the first 5 weeks,leukopenia after 5 weeks, and weight loss at 6 weeks were significantlyhigher than those in the RT alone group. In the low-dose CRT group,anorexia at 2 weeks, leukopenia after 5 weeks, and weight loss between 3and 4 weeks were significantly higher than those in the RT alone groupbut the levels of toxicities were lower than those in the high-dose CRTgroup. There was no significant difference in the pattern of diarrheabetween the RT alone and high-dose CRT groups, and it was significantlylower in the low-dose CRT group compared with RT alone.Conclusion: These data can help us to understand when patients arelikely to develop maximal toxicities and to manage them with optimal timing