Hematologic toxicities of cisplatin concurrent chemoradiation in cervical cancer at Ubonrajchathani Cancer Center

Abstract

Background: Weekly cisplatin concurrent chemoradiation is a treatment in locally advanced cervical cancer. However, there are only few reports in Thai women about hematologic toxicities of this treatment.

Objectives: To evaluate prevalence of hematologic toxicities and early response accompanying weekly cisplatin concurrent chemoradiation in cervical cancer patients.

Methods: Medical records of cervical cancer patients treated between January 2003 to December 2005 were reviewed retrospectively. Patients were treated by weekly cisplatin 40 mg/m² accompanying with radiotherapy of total dose 7500-9000 cGy.

Design: Retrospective descriptive study

Setting: Ubonrajchathani Cancer Center, Ubonrajchathani

Results: 89 out of 95 patients diagnosed as locally advanced cervical cancer and treated by weekly cisplatin in concurrent with radiotherapy were eligible and included for analysis. Mean age was 47.5 years (range, 34-71 years). The major histologic types were squamous cell carcinoma (79.8%), and distribution according to International Federation of Gynecology and Obstetrics (FIGO) stage was IB2 19.1%, IIA 6.7%, IIB 38.2%, IIIA 2.2%, IIIB 31.5% and IVA 2.2%, respectively. 80.9% of patients received five or more cycles of weekly cisplatin. Prevalence of hematologic toxicities was 78.7% and grade 3-4 were found in 14.4% of the patients. There were leukopenia 64.0% (9% grade 3-4), neutropenia 40.4% (7.8% grade 3-4), anemia 57.3% (only 1.1% grade 3-4) and no grade 3-4 thrombocytopenia. Only one patient (1.1%) had febrile neutropenia and this was manageable. There was no significant factor associated with clinical response in this study. Clinical response was evaluated. Complete response was 86.5%, partial response was 13.5%.

Conclusions: Prevalence of hematologic toxicities accompanying with weekly cisplatin concurrent chemoradiation was 78.7% and grade 3-4 were found in 14.4% of the patients. Hemotologic toxicities were acceptable and managable. Complete clinical response rate was high.