Radical treatment with weekly cisplatin (wCDDP) plus concurrent radiotherapy (XRT) in locally advanced cervical cancer (LACC) patients (pts): A mono-institutional experience.

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e15556 Background: Platinum-based radical chemoradiation is the standard treatment for LACC (stage Ib2-IV) pts. We describe in this report the activity and tolerability concurrent wCDDP and XRT in LACC pts treated in our Department. Methods: Between May 2001 and July 2009, we have treated a consecutive series of 40 patients with whole pelvic external XRT (plus XRT boost in patients with parametrial invasion) and brachytherapy (B) in selected cases (with good clinical response to external XRT). We administered weekly CDDP at the dose of 40 mg/sqm for a total of 4-6 courses, starting on XRT day 1. Results: Pts characteristics were: median age 54 yrs (30-78); median PS 0 (0-2); FIGO stage: Ib2 in 5 pts, IIb in 15, IIIa in 1, IIIb in 13, IVa in 3, and IVb (without visceral metastasis) in 3. Histology: squamous in 33 pts and adenocarcinoma in 5, undifferentiated in 1, and unknown in 1.The pts received an external XRT for a median total dose of 50.4 Gy (range 40-67); XRT boost was delivered in 7 cases (median dose 0.9 Gy; range 0.6-1.8); B was performed in 20 pts, who received a B dose ranging from 10.5 to 33.5 Gy (median 30). The treatment was completed in 82.5% of the pts. The median number of delivered CT courses was 5 (range 1-8). Major acute toxicities consisted of grade 3 neutropenia (2 pts), grade 3 anemia (1 pt), grade 3 diarrhoea (1 pt), grade 3 constipation (1 pt), grade 3 fatigue (1 pt). In one case, a blood transfusion was required. We observed one case of febrile neutropenia (requiring GCSF), without major infection. According to the LENT-SOMA toxicity score, we observed the following XRT-related late toxicities: grade 1/2 rectal in 3/1 pts respectively, grade 2 urinary in 1 pt, grade 2 sexual in 1 pt, grade 2 bone in 1 pt. The response rate was 95 % (6 CR and 32 PR). After a median follow-up of 27 mos (range 4-75), the 2-year OS and DFS were 94.4 % and 77.2 % respectively, with median OS and DFS not reached. Conclusions: Our experience with concurrent wCDDP + XRT in LACC confirms the good activity and tolerability of this treatment and appears super imposable to the literature data. No significant financial relationships to disclose.

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