A Preliminary Results of a Randomized Trial Comparing Monthly 5-flourouracil and Cisplatin to Weekly Cisplatin Alone Combined with Concurrent Radiotherapy for Locally Advanced Cervical Cancer
2
조회
0
다운로드
0
인용
0
참고문헌
초록
Abstract
Purpose: To determine the superior chemotherapeutic regimen between monthly 5-FU plus cisplatin (FP) and weekly cisplatin alone in concurrent chemoradiotherapy for locally advanced cervical cancer, the compliance of treatment, response, survival and toxicities were analyzed between the two arms. Materials and Methods: Between March 1998 and December 2001, 61 patients with locally advanced cervical cancer (stage IIB through IVA) and negative para-aortic lymph nodes were randomly assigned to either 'monthly FP' (arm I, n=34) or 'weekly cisplatin' (arm II, n=27) with concurrent radiotherapy. The patients of arm I received FP (5-FU 1,000 mg/m2/day cisplatin 20 mg/m2/day, for 5 days, for 3 cycles at 4 week intervals) and those of arm II received cisplatin (30 mg/m2/day, for 6 cycles at 1 week intervals) with concurrent radiotherapy. The radiotherapy consisted of 41.4~50.4 Gy external beam irradiation in 23~28 fractions to the whole pelvis, with high dose rate brachytherapy delivering a dose of 30~35 Gy in 6~7 fractions to point A. During the brachytherapy, a parame-trial boost was delivered. The median follow-up period for survivors was 44 months. Results: The compliance of treatment in monthly FP weekly cisplatin arms were 62 and 81%, respectively. The complete response rates at 3 months were 96 and 88% in arms I and II, respectively. The 4-year overall survival and disease free survival rates were 64 and 54% in the arm I and 77 and 66% in the arm II, respectively. The incidence of hematologic toxicity more than grade 2 was 29% in the arm I and 15% in the arm II. Only one patient in arm I experienced grade 3 gastrointestinal toxicity. No severe genitourinary toxicity was observed. Conclusion: No significant difference was observed in the compliance, responses, survival rates and acute toxicities between the two treatment arms. More patients and further follow up will be required.
참고문헌 (25)
- "result of postoperativeirradiation in patients with microscopic infiltration in theparametrium and", or lymph node metastasis, 1989, 389~95
- "The patterns of care outcome study for cancer of the uterinecancer:Results of the second national practice survey", 66, pp.2451~6 (1990)
- "Analysis of sites andcauses of failures of irradiation in invasive squamous cellcarcinoma of the intact uterine cervix", 115, pp.681~5 (1975)
- "Radiotherapy with or without misonidazolein patients with stage IIIB or IVA squamous cell carcinomaof the uterine cervix:preliminary report of a radiation therapyoncology group randomized trial", 13, pp.541~9 (1987)
- "a radiation potentiator in carcinoma of the uterine cervix", pp.803~8 (1983)
- "Combined treatment of radiation and cisdiaminedichloroplatinum a review of experimental and clinical data", pp.403~26 (1987)
- "Randomized trial of epirubicin and cisplatinchemotherapy followed by pelvic radiation in locally advancedcervical cancer", 13, pp.444~51 (1995)
- "Chemotherapy followed by radiotherapy versus radiotherapyalone in locally advanced cervical cancer:a randomizedstudy", 54, pp.307~15 (1994)
- "A randomized trial of chemotherapy followed bypelvic radiation therapy in stage IIIB carcinoma of the cervix", 9, pp.970~7 (1991)
- "Pelvic radiation with concurrent chemotherapy comparedwith pelvic and para-aortic radiation for high-riskcervical cancer", 340, pp.1137~43 (1999)
- "Concurrent cisplatin-based radiotherapyand chemotherapy for locally advanced cervical cancer", 340, pp.1144~53 (1999)
- "Randomized comparison of fluorouracilplus cisplatin versus hydroxyurea as an adjuvant to radiationtherapy in stage IIB-IVA carcinoma of the cervix withnegative para-aortic lymph nodes:a Gynecologic OncologyGroup and Southwest Oncology Group study", 17, pp.1339~48 (1999)
- "Concurrent chemoradiation for cervicalcancer" (1999), Clinical announcement
- "Chemotherapy and irradiationin locally advanced squamous cell carcinoma of the uterinecervix: A review", 7, pp.45~65 (1997)
- "Biological basis for the interaction of chemotherapeuticagents and radiation therapy", pp.9 2123~30 (1985)
- "Chemotherapyadded to locoregional treatment for head and neck squamouscellcarcinoma three meta-analyses of updated individual data", 335, pp.949~55 (2000)
- "Intraarterial cisplatin and concurrent radiation forlocally advanced bladder cancer", 7, pp.230~5 (1989)
- "Cisplatin,radiation,and adjuvant hysterectomycompared with radiation and adjuvant hysterectomy forbulky stage IB cervical carcinoma", 340, pp.1154~61 (1999)
- "Cisplatin and 5-fluorouracil plus radiation therapy aresuperior to radiation therapy as adjunctive in high-risk earlystagecarcinoma of the cervix after radical hysterectomy andpelvic lymphadenectomy:Report of a phase III intergroupstudy", 72, pp.443~527 (1999)
- "The effect of treatmentduration in the local control of cervix cancer", 25, pp.273~9 (1992)
- "The influenceof treatment time on outcome for squamous cell cancer of theuterine cervix treated with radiation", pp.391~7 (1993)
- "The adverse effect of treatment prolongationin cervical carcinoma", 32, pp.1301~7 (1995)
- "Dose-tumorresponse of carcinoma of cervix an analysis of 594 patientstreated by radiotherapy", pp.311~7 (1993)
- "Pilot study of concurrent cisplatin,5-fluorouracil,and external beam radiotherapy prior to radical surgery+", - intraoperative electron beam radiotherapy in locallyadvanced cervical cancer, 1999, pp.74, 30~7
- "Prospective phase I", II studies of definitive irradiationand chemotherapy for advanced gynecologic malignancies., 1996, 1~6