Concurrent Chemo-brachytherapy with Cisplatin and intracavitary brachytherapy in locally advanced uterine cervical cancer

Background: advanced uterine cervical cancer is usually treated with concurrent cisplatin and extemal radiotherapy and then low dose rate of intracavitary brachytherapy (icbrt). in this prospective clinical trial we evaluated the efficacy of concurrent cispletin and medium dose rate (mdr-1cbrt). methods: patients with locally advanced cervical cancer (stage ib2-iva) who were candidates for radical radiotherapy recruited in this study. they were treated with chemoradiation by extemal radiotherapy and mdr-lcbrt by24 gy in two fractions concurrently with 35 mg/m2 cisplatin from october 2007 to may 2008. response rate, local control and acute and late effects of treatment were evaluated using who scale.results: forty patients with uterine cervical carcinoma were enrolled in this study. nine patients did not return for follow-up and were excluded. therefore, we assessed response rate, acute and late effects in 31 cases. the median time of follow-up was 13 months (4-20 months). most of the patients (29 cases) were in stage lib of cervical tumor. twelve months overall survival was 78%and 22 cases were disease free. local tumor recurrence was noted in two patients . one patient developed bone metastasis and six deceased because of tumor progression. acute effects were abdomin al pain in 23%, cystitis in 19%, vaginitis in 18%, and proctitis in 15% of cases. there were grade 1 and 2 leucopenia in 85% and %15 and grade 1 and 2 anemia in 95 % and 5% of the cases, respectively; there were no grade 3-4 acute toxicities. late effects were cystitis in 24%, proctitis in 12%, abdominal pain in 4%, and rectal fistula in 3% of cases.conclusion: in this study, the efficacy of concurrent cisplatin and mdr-icbrt in advanced cervical tumors was assessed. acute effects specially hematological and renal toxicities, subjective complaints and response rate were acceptable. although evaluation of rectal and bladder late effects were not completed because of the short period of follow up, it seems that sub-acute effects (seen in 6-20 months after therapy) were acceptable.