COMBINATION OF RADIOTHERAPY AND CISPLATIN BY CONTINUOUS INFUSION IN LOCALLY ADVANCED CERVICAL-CANCER - PRELIMINARY-RESULTS

Thanks to surgery and radiation therapy, the prognosis of early-stage carcinoma of the cervix is excellent, however, in locally advanced disease it is still poor. We report here the preliminary results of a retrospective study in which 29 patients with locally advanced disease were treated with radiation combined with cisplatinum between December 1987 and January 1990. The numbers of patients for each stage were as follows : 1b = 6, IIa = 5, IIb = 6, IIIa = 7, IIIb = 9, IVa = 1. Radiation therapy was administered at 1,8 to 2 Gy / day to a mean total of 44 Gy. 28 patients received a continuous infusion of cisplatinum during the 2nd week of the radiation, associated in 4 cases to a continuous infusion of 5-FU, and 1 patient was treated with a combination of cisplatinum, vindesine and bleomycin. In addition, 23 patients received intracavitary brachytherapy and 6 a boost of external beam pelvic irradiation. Simple or extended hysterectomy was performed in 15 patients 6 weeks following brachytherapy. Local control was achieved in 72,4 % of cases and was not correlated to surgery (p = 0,17). However, actuarial overall survival was 84, 1 % at 1 year and 77,2 % at 2 years, with 100 % 2-year survival in operated patients versus 66 % in conservatively treated ones (p = 0,01). Disease-free survival was 77,9 % at 1 year. Based on these results, which are comparable to the literature and seems better than those obtained with radiation therapy alone, we have initiated a prospective trial using concomitant radiation and cisplatinum.