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Retrospective Analysis of Concomitant Cisplatin During Radiation in Patients Aged 55 Years or Older for Treatment of Advanced Cervical Cancer: A Gynecologic Oncology Group Study
  1. Charles Kunos, MD, PhD*,
  2. Chunqiao Tian, PhD,
  3. Steven Waggoner, MD,
  4. Peter G. Rose, MD§ and
  5. Rachelle Lanciano, MD
  1. *Department of Radiation Oncology, Case Comprehensive Cancer Center and University Hospitals of Cleveland Case Medical Center, Cleveland, Ohio;
  2. Gynecologic Oncology Group Statistical and Data Center, Roswell Park Cancer Institute, Buffalo, NY;
  3. Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Case Comprehensive Cancer Center and University Hospitals of Cleveland Case Medical Center;
  4. §Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Case Comprehensive Cancer Center and The Cleveland Clinic, Cleveland, OH; and
  5. Department of Radiation Oncology, Delaware County Memorial Hospital, Drexel Hill, PA.
  1. Address correspondence and reprint requests to Charles Kunos, MD, PhD, Department of Radiation Oncology, University Hospitals Case Medical Center, 11100 Euclid Ave, LTR 6068, Cleveland, Ohio 44106. E-mail: charles.kunos{at}uhhospitals.org.

Abstract

Hypothesis: Patients with stages II to IVa cervical cancer aged 55 years or older were compared with patients younger than 55 years who received weekly cisplatin during pelvic radiation for differences in chemoradiation administration, toxicity, and outcome.

Methods: Retrospective review included patients enrolled on Gynecologic Oncology Group trial Nos. 120 and 165 (n = 335) who received weekly cisplatin (40 mg/m2) during pelvic irradiation (40.8-50.1 Gy) followed by intracavitary brachytherapy (30-40 Gy).

Results: For all 335 patients, 53% completed 6 cycles of chemotherapy during radiation with no observed difference in frequency among patients younger than 55 years or 55 years or older (P = 0.616). Excess hematological but not genitourinary toxicity was seen in patients 55 years or older. At 5 years, 56% of patients younger than 55 years were predicted to be alive and disease-free compared with 55% of those aged 55 years or older (P = 0.629). A 5-year survival was 60% in patients younger than 55 years as compared with 56% in patients aged 55 years or older (P = 0.265).

Conclusions: Patients aged 55 years or older with locally advanced cervical cancer undergoing concurrent weekly cisplatin with pelvic radiation on cooperative group clinical trials achieve similar progression-free and overall survivals as younger patients. Disparity was not observed in the seriousness or frequency of treatment-related sequelae.

  • Cervical cancer
  • Chemoradiation
  • Elderly

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Footnotes

  • This study was supported in part by a grant (K12 CA076917) to C.K. from the National Institutes of Health and the Case Comprehensive Cancer Center and also by National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office (CA 27469) and the Gynecologic Oncology Group Statistical Office (CA 37517).

  • The following member institutions participated in this study: University of Alabama at Birmingham, Oregon Health Sciences University, Duke University Medical Center, Abington Memorial Hospital, University of Rochester Medical Center, Walter Reed Army Medical Center, Wayne State University, University of Minnesota Medical School, Emory University Clinic, University of Southern California at Los Angeles, University of Mississippi Medical Center, Colorado Gynecologic Oncology Group, PC, University of California at Los Angeles, University of Washington, University of Pennsylvania Cancer Center, University of Miami School of Medicine, Milton S. Hershey Medical Center, Georgetown University Hospital, University of Cincinnati, University of North Carolina School of Medicine, University of Iowa Hospitals and Clinics, University of Texas Southwestern Medical Center at Dallas, Indiana University School of Medicine, Wake Forest University School of Medicine, Albany Medical College, University of California Medical Center at Irvine, Tufts-New England Medical Center, Rush-Presbyterian-St Luke's Medical Center, SUNY Downstate Medical Center, University of Kentucky, Eastern Virginia Medical School, The Cleveland Clinic Foundation, Johns Hopkins Oncology Center, State University of New York at Stony Brook, Eastern Pennsylvania GYN/ONC Center, PC, Cooper Hospital/University Medical Center, Columbus Cancer Council, University of Massachusetts Medical School, Fox Chase Cancer Center, Medical University of South Carolina, Women's Cancer Center, University of Oklahoma, University of Virginia Health Sciences Center, University of Chicago, University of Arizona Health Science Center, Tacoma General Hospital, Mayo Clinic, Case Western Reserve University, Tampa Bay Cancer Consortium, and The New York Hospital/Cornell Medical Center.

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