Concurrent daily cisplatin and extended-field radiation therapy for carcinoma of the cervix
Concurrent daily cisplatin and extended-field radiation therapy for carcinoma of the cervix
复制标题
DOI：
10.1111/j.1525-1438.2007.00960.x
复制
发表时间：
2008-01-01
影响因子：
4.8
通讯作者：
Ito, H.
中科院分区：
文献类型：
--
作者：
Uno, T.;Mitsuhashi, A.;Ito, H.
本研究的目的是评估并发低剂量每日顺铂和大范围放射治疗 (EFRT) 对宫颈癌的急性毒性。对 15 名患有宫颈癌的女性进行了分析，她们每日同时接受低剂量顺铂和 EFRT 治疗。每日顺铂剂量固定为 8 mg/m(2)，这是在之前使用盆腔放射治疗的 I 期研究中确定的。 12 名患者接受了外束放射治疗和腔内近距离放射治疗的联合治疗或单独的外束放射治疗。另外三名患者术后接受辅助放化疗。 EFRT 的总剂量范围为 40 至 45 Gy，肿瘤总体积额外增加至 50.4-55 Gy。整个放射治疗过程中顺铂的中位总剂量为224 mg/m(2)（范围200-240 mg/m(2)）。 15 名患者中有 14 名 (93%) 可以按计划连续每天服用顺铂，无需任何修改。只有一名患者的顺铂给药仅中断 3 天。 14 名患者出现 2 级或更严重的白细胞减少症，其中 5 名患者在治疗后出现白细胞减少症，4 名患者出现 2 级白细胞减少症，8 名患者出现 3 级白细胞减少症，两名患者出现 4 级白细胞减少症。 3 名患者出现 3 级血小板减少症。 12 名患者出现 2 级或更严重贫血。三名患者出现 3 级非血液学毒性，两名患者出现腹泻，一名患者出现恶心/呕吐。尽管中度至重度血液学毒性很常见，但本研究表明，每日同时使用低剂量顺铂和 EFRT 是可行的。放射治疗期间顺铂累积剂量大于 200 mg/m(2) 可以通过使用每日 8 mg/m(2) 顺铂剂量来实现。
The aim of this study was to assess acute toxicities of concurrent low-dose daily cisplatin and extended-field radiation therapy (EFRT) for carcinoma of the uterine cervix. Fifteen women with cervical cancer who were treated with concurrent daily low-dose cisplatin and EFRT were analyzed. Daily cisplatin dose was fixed to 8 mg/m(2), which was determined in the preceding phase I study using pelvic radiotherapy. Twelve patients underwent either combined external beam radiation therapy and intracavitary brachytherapy or external beam radiation therapy alone. Three other patients were treated with adjuvant chemoradiotherapy after surgery. A total dose of EFRT ranged from 40 to 45 Gy, with an additional boost to the gross tumor volume up to 50.4-55 Gy. A median total dose of cisplatin during entire radiation therapy course was 224 mg/m(2) (range, 200-240 mg/m(2)). In 14 of 15 patients (93%), daily cisplatin could be delivered continuously as planned without any modification. Administration of cisplatin had to be interrupted in only one patient for only 3 days. Fourteen patients developed grade 2 or worse leukopenia including five after treatment, grade 2 in four, grade 3 in eight, and grade 4 in two. Grade 3 thrombocytopenia was observed in three patients. Grade 2 or worse anemia was observed in 12. Three patients had grade 3 nonhematologic toxicities, diarrhea in two, and nausea/vomiting in one. Although moderate to severe hematologic toxicities are common, this study suggests that concurrent low-dose daily cisplatin and EFRT are feasible. A cumulative cisplatin dose of greater than 200 mg/m(2) during radiation therapy could be achieved by using daily cisplatin dose of 8 mg/m(2).