Význam intenzity chemoterapie v konkomitantní
chemoradioterapii lokálně pokročilého karcinomu
hrdla děložního
Sirák I., Petera J., Odrážka K., Doležel M., Zoul Z., Vaculíková M.
Klinika onkologie a radioterapie LF UK a FN, Hradec Králové, přednosta doc. MUDr. J. Petera, Ph.D. |
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Souhrn:
Objective: Concurrent chemoradiotherapy with weekly cisplatin became a standard procedure in
patients with locally advanced cervical carcinoma. The objective of this retrospective study was to
evaluate the therapy toleration and the survival of patients with locally advanced cervical cancer treated
with concurrent chemoradiotherapy with weekly cisplatin of 40mg/m2.
Subject and Method: From January 2000 to December 2004, 40 patients with locally advanced cervical
cancer were treated with concurrent chemoradiotherapy with weekly cisplatin of 40mg/m2. Radical
radiotherapy consisted of external beam radiotherapy 25 x 2 Gy to the pelvis, high-dose rate
brachytherapy 6 x 4 Gy to the tumor, boost 7 x 2 Gy to the pelvic walls. 21 patients also recieved 22 x 2
Gy to the para-aortic lymphatic nodes.
Results: Only 16 patients recieved full five doses of cisplatin. Causes of discontinuance of the
chemotherapy : acute hematological toxicity with leukopenia (10), thrombocytopenia (1), anaemia (1),
increased levels of creatinine (2), profuse vomiting (1), haematemesis (1). Stage dependent two-year
overall survival (OS) was 72% (IIB) against 64% (III, IVA). Two-year disease-free survival (DFS)
dependent on the number of cisplatin doses was 77% (≥ 3 doses) against 56% (<3 doses) in patients with
IIB stage.
Conclusion: Acute hematological toxicity with leukopenia was the most frequent cause of discontinuance
of the chemotherapy. The results of two-year OS and DFS show difference in dependence on the number
of applied doses of chemotherapy. However, the difference was not significant due to a low number of
patients subject to the study.
Klíčová slova:
cervical carcinoma, concurrent chemoradiotherapy, cisplatin, leukopenia
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