122. Chemoradiotherapy in advanced cervical cancer

ObjectiveThe ability of radiotherapy to cure locally advanced cervical cancer is limited by the size of the tumor; because the doses required treating large tumor exceed the limit of toxicity in normal tissue. Efforts to overcome this problem have included the use of different radiation-fractionation schedules, use of radiomodifiers or the concurrent use of chemotherapy.Material and methodFifty five patients aged 27 – 78 with squamous cell cervical cancer stage III, T1N0-1M0 were treated in our department. According the treatment schedule all patients were subdivided into three groups, including control one.The radiotherapy regimens were similar in all groups – external irradiation to a dose 20–30 Gy/10–15 fractions/2–3 weeks (opposite fields techniques) then we continued the ERT up to the total dose 50–55 Gy and brachytherapy boost (60Co HDR-sources) to a dose 40–50 Gy/4–5 fractions/4–5 weeks. External radiotherapy (ERT) was carried out using 60Co-units or linear accelerator “Mevatron” usage.1st group included 26 patients with endophytic growth, massive parametral infiltrates mainly; 2nd group – 14 patients with exophytic and mixed forms, involving vaginal walls predominantly. The patients of these both groups received radiomodifiers during the radiotherapy. 3rd group included 15 patients who received radiotherapy alone. The patients of the 1st group received 5-fluoruoracil infusions during 5 days before radiotherapy (350 mg/m2/day), then first three sessions were carried out on the background of cysplatinum to a total dose of 60 mg/m2. In the 2nd group radiation was carried out on the background of lymphotropic infusion of metotrexate to a dose of 10 mg/m2 twice a week until a total dose of 40 mg/m2.ResultsAnalysis of immediate results demonstrated that in 1st group complete response (CR) toccured in 3 patients, partial response (PR) – in 2 patients, in 1- stabilization of disease (SD). In 2nd group -CR – in 2 pts, PR -in 8, SD – in 3, prolongatio morbi – in 1. In control group CR was registered in 1 patient, PR – in 6, SD – in 8.ConclusionThese data showed good patient tolerance and encouraging response to RT combined with chemotherapy