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Title: Multi-institutional Observational Study of Prophylactic Extended-Field Concurrent Chemoradiation Therapy Using Weekly Cisplatin for Patients With Pelvic Node-Positive Cervical Cancer in East and Southeast Asia
Authors: Masaru Wakatsuki
Shingo Kato
Tatsuya Ohno
Parvin Akhter Banu
Nguyen Cong Hoang
Erdenetuya Yadamsuren
Nana Supriana
Jianping Cao
C. R.Beena Devi
Miriam Joy Calaguas
Yaowalak Chansilpa
Chul Koo Cho
Tasbolat Adylkhanov
Noriyuki Okonogi
Takashi Nakano
Hirohiko Tsujii
The First Affiliated Hospital of Soochow University
Jichi Medical University
Semey Medical University
St. Luke's Medical Center Quezon City
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Korea Institute of Radiological and Medical Sciences
Saitama Medical University
National Institute of Radiological Sciences Chiba
Faculty of Medicine, Siriraj Hospital, Mahidol University
Sarawak General Hospital
Gunma University Faculty of Medicine
Delta Hospitals Limited
National Cancer Center
National Cancer Hospital
Keywords: Biochemistry, Genetics and Molecular Biology;Medicine
Issue Date: 1-Sep-2019
Citation: International Journal of Radiation Oncology Biology Physics. Vol.105, No.1 (2019), 183-189
Abstract: © 2019 Elsevier Inc. Purpose: This multi-institutional observational study conducted among 11 countries in East and Southeast Asia aimed to assess the clinical outcomes of prophylactic extended-field concurrent chemoradiation therapy using weekly cisplatin for patients with locally advanced cervical cancer. Methods and Materials: Between October 2007 and May 2016, 106 patients with untreated squamous cell carcinoma of the cervix were enrolled in the present study. Radiation therapy consisted of pelvic irradiation (total dose, 50 Gy in 25 fractions including central shielding), prophylactic paraortic regional irradiation (36-40 Gy in 20 fractions), and either high- or low-dose-rate intracavitary brachytherapy (ICBT) according to institutional practice. The planned point A dose was 21 to 28 Gy in 3 to 4 fractions for high-dose-rate ICBT and 40 to 41 Gy in 1 to 2 fractions for low-dose-rate ICBT. Five cycles of weekly cisplatin (40 mg/m2) were administered during the radiation therapy course. Results: A total of 106 patients were enrolled. Of these, 9 had major protocol violations and 2 did not receive treatment because of worsened general condition. Thus, 95 patients were evaluable. The median follow-up was 56 months. Of the 95 patients, 76 (80%) received 4 or 5 cycles of chemotherapy. Acute grade 3 leukopenia was observed in 20 of the patients (21%), and late grade 3 gastrointestinal toxicity was observed in 3%. The 2-year local control, progression-free survival, and overall survival rate for all patients were 96%, 78%, and 90%, respectively. Conclusions: The results indicated that prophylactic extended-field concurrent chemoradiation therapy using weekly cisplatin is feasible and effective for patients with locally advanced cervical cancer in East and Southeast Asia.
ISSN: 1879355X
Appears in Collections:Scopus 2019

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