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Daily Low-Dose Cisplatin-Based Concurrent Chemoradiotherapy for the Treatment of Cervical Cancer in Patients 70 Years or Older
  1. Shinsuke Hanawa, MD*,
  2. Akira Mitsuhashi, MD, PhD*,
  3. Hirokazu Usui, MD, PhD*,
  4. Noriko Yamamoto, MD, PhD*,
  5. Miho Watanabe-Nemoto, MD, PhD,
  6. Kyoko Nishikimi, MD*,
  7. Takashi Uehara, MD, PhD*,
  8. Shinichi Tate, MD, PhD*,
  9. Takashi Uno, MD, PhD and
  10. Makio Shozu, MD, PhD*
  1. *Departments of Reproductive Medicine and
  2. Departments of Radiology, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
  1. Address correspondence and reprint requests to Akira Mitsuhashi, MD, PhD, 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

Objectives It has been established that concurrent chemoradiotherapy (CCRT) is efficacious for cervical cancer, but adherence is unsatisfactory among elderly patients. To improve adherence, we have developed and initiated a daily low-dose cisplatin-based CCRT regimen. Here, we retrospectively evaluated the use of CCRT, especially for elderly patients.

Methods The study included a total of 53 patients who were 70 years or older, had stage IB-IVA cervical cancer, and were initially treated with daily CCRT. 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 was 72 years (range, 70–85 years). The median follow-up duration was 32 months (range, 2–104 months). The 3-year overall survival rate was 79.0%. Daily cisplatin chemotherapy was successfully completed in 32 (60.4%) of the 53 patients. Grade 3 or 4 neutropenia was observed in 19 patients (36%). A late complication of grade 3 rectal hemorrhage occurred in 3 patients who received high-dose-rate brachytherapy. All primary tumors responded to daily CCRT; complete response was observed in 43 patients (91.5%) and partial response was observed in 4 patients (8.5%).

Conclusions Daily CCRT in patients 70 years and older had acceptable compliance and safety. Daily CCRT is suggested to be a good treatment option for elderly patients who have advanced cervical cancer and require concurrent cisplatin.

  • Cervical cancer
  • Chemoradiotherapy
  • Elderly
  • Low-dose cisplatin

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Footnotes

  • The authors declare no conflicts of interest.

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