Taehan Sanbuinkwa Hakhoe chapchi; Korean journal of obstetrics and gynecology; 대한산부인과학회잡지
Objective: The purpose of this study was to evaluate the efficacy and toxicity of concurrent chemor- adiotherapy (CCRT) in loco-regionally advanced cervical cancer patients. Methods: The medical records of 24 patients were retrospectively reviewed who underwent CCRT' and 62 patients who had underwent radiation therapy alone at the Department of Obstetrics and Gynecology, Ajou University Hospital from September, 1994 to August 2000 for loco-regionally advanced cervical cancer (stage Ⅱb-Ⅳa and Ⅰb-Ⅱa with bulky tumor mass or pelvic lymph node involvement detected by magnetic resonance imaging). Radiotherapy was performed for 7 weeks during which the patients underwent radiotherapy and chemotherapy concomitantly.
Chemotherapeutic regimen consisted of cisplatin (75 ㎎/㎡ on day 1, 4) and 5-FU (1000 ㎎/㎡ on day 2-5, 30-33). The toxicity was assessed according to the GOG toxicity criteria. Results: In the CCRT group, 2 of 18 patients (11.1%) had recurrent disease. Of the 22 patients who were followed up, the overall survival rate was 83.3%, and the relapse-free survival rate was 89.9%. In the radiotherapy alone group, 19 of 61 patients (32.3%) had recurrent disease. Of the 62 patients who were followed up, the overall
survival rate was 75.4% and the relapsed-free survival rate was 67.7%. Relative risk reduction rate of the death rate in the CCRT group was 66% (RR 0.34), and 32% (RR 0.68) in the recurrence rate. Acute toxicities in the CCRT group were enteritis grade
3:3 (12.5%), leukopenia grade 3:2 (8.3%), anemia grade 3:1 (4.1%) and grade 4:2 (8.3%). The acute toxicities in the radiation therapy alone group were enteritis grade 3:7 (11.3%), rectal bleeding grade 3:1 (1%). Increased acute toxicities developed
in the CCRT group. Conclusion: This study shows improved overall survival rates and relapse-free survival rates but some increase in acute toxicity. It is suggested that CCRT be the standard treatment of loco-regionally advanced cervical cancer. Due
to small size sample and short duration of follow up, further study of a large group of patients and the long term survival rate are necessary.
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