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Daily Low-Dose Cisplatin-Based Concurrent Chemoradiotherapy in Patients With Uterine Cervical Cancer With Emphasis on Elderly Patients: A Phase 2 Trial
  1. Akira Mitsuhashi, MD, Ph.D*,
  2. Takashi Uno, MD, Ph.D,
  3. Hirokazu Usui, MD, Ph.D*,
  4. Kyoko Nishikimi, MD*,
  5. Noriko Yamamoto, MD*,
  6. Miho Watanabe, MD,
  7. Shinichi Tate, MD, Ph.D*,
  8. Koichiro Hirashiki, MD, Ph.D*,
  9. Kazuyoshi Kato, MD, Ph.D*,
  10. Koji Yamazawa, MD, Ph.D* and
  11. Makio Shozu, MD, Ph.D*
  1. *Departments of Reproductive Medicine and
  2. Departments of Radiology, Graduate School of Medicine, Chiba University, Chiba, Japan.
  1. Address correspondence and reprint requests to Akira Mitsuhashi, MD, Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan. E-mail: antira@faculty.chiba-u.jp.

Abstract

Objective We evaluated the usefulness of daily low-dose cisplatin-based concurrent chemoradiotherapy (daily CCRT) in patients with cervical cancer with an emphasis on elderly patients.

Methods Between January 2003 and December 2008, a total of 65 patients with untreated stage IIA to IIIB cervical cancer were enrolled and 54 were selected for this nonrandomized prospective study. The daily CCRT comprised pelvic external beam radiotherapy (2 Gy/d × 25) with daily low-dose cisplatin (8.0 mg/m2 per day) and either low- or high-dose rate intracavitary brachytherapy.

Results The median age of the patients was 62 years (range, 29–85 years), and 21 patients (39%) were 70 years or older. The median follow-up period was 47 months (range, 4–107 months). Daily CCRT was successfully completed in 91% (49/54) of the patients. The mean total cisplatin dose was 191 mg/m2 (range, 128–224 mg/m2), and a neutropenia grade higher than 3 was observed in 24% of the patients. Of the 21 patients 70 years or older, 17 (81%) completed daily CCRT with acceptable toxicity. The 3-year overall survival (OS) rate for all the patients was 82.9%. No statistically significant differences in the OS rate and toxicity were observed between patients 70 years or older and those younger than 70 years.

Conclusions Daily CCRT showed acceptable toxicity and compliance, leading to the use of a high total dosage of cisplatin. The OS rate for daily CCRT was comparable to that for previously reported weekly CCRT. Daily CCRT could be an alternate choice for the CCRT treatment in elderly patients with cervical cancer.

  • Cervical cancer
  • Concurrent chemoradiation
  • Daily low-dose cisplatin
  • Elderly patient

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Footnotes

  • There are no financial disclosures from any authors.

  • The authors declare no conflicts of interest.

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