J Gynecol Oncol.  2012 Oct;23(4):235-241. 10.3802/jgo.2012.23.4.235.

Comparison of concurrent chemoradiation therapy with weekly cisplatin versus monthly fluorouracil plus cisplatin in FIGO stage IIB-IVA cervical cancer

• Kong TW
• Chang SJ
• Paek J
• Yoo SC
• Yoon JH
• Chang KH
• Chun M
• Ryu HS

• KMID: 1810120
• DOI: http://doi.org/10.3802/jgo.2012.23.4.235

Abstract

OBJECTIVE
Concurrent chemoradiation therapy (CCRT) is the standard treatment for locally advanced cervical cancer. Although the optimal chemotherapeutic regimen is not yet defined, previous randomized trials have demonstrated that 5-fluorouracil (5-FU) plus cisplatin every 3 weeks and weekly cisplatin are the most popular regimens. The purpose of this study was to compare the outcomes of weekly CCRT with cisplatin and monthly CCRT with 5-FU plus cisplatin for locally advanced cervical cancer.
METHODS
We retrospectively reviewed data from 255 patients with FIGO stage IIB-IVA cervical cancer. Patients were classified into two CCRT groups according to the concurrent chemotherapy: weekly CCRT group, consisted of CCRT with weekly cisplatin for six cycles; and monthly CCRT group, consisted of CCRT with cisplatin and 5-FU every 4 weeks for two cycles followed by additional consolidation chemotherapy for two cycles with the same regimen.
RESULTS
Of 255 patients, 152 (59.6%) patients received weekly CCRT and 103 (40.4%) received monthly CCRT. The mean follow-up period was 39 months (range, 1 to 186 months). Planned CCRT was given to 130 (85.5%) patients in weekly CCRT group and 84 (81.6%) patients in monthly CCRT group, respectively. Severe adverse effects were more common in the monthly CCRT group than in the weekly CCRT group. There were no statistically significant differences in progression-free survival and overall survival between the two groups (p=0.715 and p=0.237).
CONCLUSION
Both weekly CCRT and monthly CCRT seem to have similar efficacy for patients with locally advanced cervical cancer, but the weekly cisplatin is better tolerated.

Keyword

Concurrent chemoradiation therapy; Locally advanced cervical cancer; Survival

MeSH Terms

Cisplatin
Consolidation Chemotherapy
Disease-Free Survival
Fluorouracil
Follow-Up Studies
Humans
Retrospective Studies
Uterine Cervical Neoplasms
Cisplatin
Fluorouracil

Figure

• 

  Fig. 1 Progression-free (A) and overall survival (B) according to the type of concurrent chemoradiation therapy (CCRT) in 255 locally advanced cervical cancer patients. The 5-yr progression-free survival and overall survival of patients in the group given weekly CCRT versus monthly CCRT are 74.6% vs. 64.3% and 78% vs. 73%, respectively. FP, 5-fluorouracil plus cisplatin.

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