Abstract:

Objective     To compare the outcome of the cisplatin-based chemotherapy with 5-fluoracil (RT+FC), taxel (RT+TC) two regimens concurrent chemo-radiotherapy with standard weekly single agent cisplatin and concurrent radiation therapy (RT+DDP). MethodsPatients with locally advanced cervical squamous cell cancer of stage IIB, IIIA,IIIB, and IVA with clinically negative aortic nodes were eligible. Pelvic RT dose was 45-50Gy  and  high -dose rate intracavitary brachytherapy. The standard arm had weekly cisplatin 30mg/m2 per week lasting 5-6 cycles during RT. The experimental arm had cisplatin 75mg/m2/3wk, PVI 5-FU 625mg/m2/d for 4d/3wk in the RT+FC group, and taxel 135mg/m2/3wk in the RT+TC group for 2 cycles during RT. The disease-free survival and overall survival were analyzed. The Short-term efficacy and adverse events were observed. Results    The two experimental groups had improvement in 4-year survival compared with weekly cisplatin during RT. The TC+RT group was better than the  RT+DDP group in disease-free survival. More grades 3-4 neutropenia appeared in the TC+RT group than in the other two groups, whereas less thrombocytopenia, and emesis and diarrhea occurred in the TC+RT group than the FC+RT group.There were no statistic differences of long-time irradiation-related rectum and cystic complication incidences among the three groups. Conclusion    In this study, the three arm treatment models of locally advanced squamous cell carcinoma of cervix were safe and good with tolerable adverse events. Regimen chemotherapy in combination with RT did not show improved overall survival outcome over weekly cisplatin during RT. TC+RT might lead to better disease-free survival.

Key words: Squamous cell carcinoma of cervix; Radiotherapy; Chemotherapy; Treatment outcome