J Gynecol Oncol.  2009 Sep;20(3):151-157. 10.3802/jgo.2009.20.3.151.

Acute toxicity of cyclooxygenase-2 inhibitor rofecoxib as a radiosensitizer for concurrent chemoradiation in the treatment of uterine cervical cancer

• Jung YW
• Lee SH
• Paek JH
• Nam EJ
• Kim SW
• Kim JH
• Kim JW
• Kim YT

• KMID: 2173447
• DOI: http://doi.org/10.3802/jgo.2009.20.3.151

Abstract

OBJECTIVE
To evaluate the acute toxicity of rofecoxib during concurrent use with cisplatin-based chemoradiotherapy (CCRT) in patients with cervical cancer. METHODS: We evaluated 67 FIGO stage IB2-IVA cervical cancer patients treated with CCRT between June 2002 and July 2004. The study group included patients who received rofecoxib (N=30) and the control group included patients who received CCRT only (N=37). The patients' medical records were retrospectively reviewed for patient characteristics, toxicity related to CCRT and treatment results. RESULTS: There were no significant differences in toxicity between the two groups. The most common acute grade 3/4 toxicity was neutropenia (13.3% in the study group and 21.6% in the control group). Grade 3/4 late toxicity was observed in 2 (6.6%) patients in the study group and 3 (8.1%) in the control group. There was no treatment-related deaths in either group. Six (20.0%) patients in the study group had treatment failure. In the control group, 6 (16.2%) patients experienced treatment failure. Progression-free and overall survival was 55.8+/-4.2 and 59.0+/-2.8 months, respectively, in the study group, and 69.7+/-4.3 and 71.6+/-3.6 months, respectively, in the control group. There were no differences in progression-free and overall survival between the 2 groups. CONCLUSION: Our data indicate that rofecoxib, at a dose of 25 mg twice daily, has acceptable acute toxicity as a radiosensitizer during CCRT. Although rofecoxib was not efficacious as a radiosensitizer in the present study, the benefit of rofecoxib as a radiosensitizer should be further evaluated in a prospective study.

Keyword

Cervical cancer; Efficacy; Toxicity; Rofecoxib; Chemoradiotherapy

MeSH Terms

Chemoradiotherapy
Cyclooxygenase 2
Humans
Lactones
Medical Records
Neutropenia
Retrospective Studies
Sulfones
Treatment Failure
Uterine Cervical Neoplasms
Cyclooxygenase 2
Lactones
Sulfones

Figure

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  Fig. 1 Flow diagram for patient selection. CCRT: concurrent chemoradiotherapy.

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  Fig. 2 Progression-free (A) and overall survival (B) with rofecoxib treatment. There were no differences in progression-free and overall survival between the 2 groups (p=0.46 and p=0.30, respectively).

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