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. 2017 Jun;16(3):310-315.
doi: 10.1177/1533034616655055. Epub 2016 Jul 8.

Weekly Cisplatin and Volumetric-Modulated Arc Therapy With Simultaneous Integrated Boost for Radical Treatment of Advanced Cervical Cancer in Elderly Patients: Feasibility and Clinical Preliminary Results

Rosario Mazzola  1 , Francesco Ricchetti  1 , Alba Fiorentino  1 , Niccolò Giaj Levra  1 , Sergio Fersino  1 , Gioacchino Di Paola  2 , Ruggero Ruggieri  1 , Filippo Alongi  1
Affiliations

Weekly Cisplatin and Volumetric-Modulated Arc Therapy With Simultaneous Integrated Boost for Radical Treatment of Advanced Cervical Cancer in Elderly Patients: Feasibility and Clinical Preliminary Results

Rosario Mazzola et al. Technol Cancer Res Treat. 2017 Jun.

Abstract

Background: To evaluate the feasibility and clinical preliminary results of weekly cisplatin and volumetric-modulated arc therapy to the pelvis with simultaneous integrated boost to macroscopic disease in a cohort of elderly patients.

Materials and methods: Inclusion criteria of this prospective study were age ≥70 years, Karnofsky performance status 70 to 100, locally advanced histologically proven squamous cervical carcinoma, and patients unable to undergo brachytherapy. Radiation doses prescribed were 66 Gy to the macroscopic disease and 54 Gy to the pelvic nodes in 30 fractions. Weekly cisplatin dose was 40 mg/mq.

Results: A total of 30 patients were recruited. Median follow-up was 32 months (range: 8-48 months). Median age was 72 years (range: 70-84 years). The 3-year overall survival and local control were 93% and 80%, respectively. The median time to progression was 24 months (range: 6-30 months). Analyzing clinical outcome grouping based on the stage of disease, II versus III, the 3-year overall survival was 100% and 85%, respectively. The 3-year local control was 91% for stage II and 67% for stage III. Acute and late toxicities were acceptable without severe events.

Conclusion: Weekly cisplatin and volumetric-modulated arc therapy-simultaneous integrated boost for radical treatment of advanced cervical cancer in the current cohort of elderly patients were feasible. Long-term results and prospective randomized trials are advocated.

Keywords: VMAT; advanced cervical cancer; elderly patients; gynecological malignancies.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan-Meier curves for the population of the study: (A) overall survival, (B) local control.
Figure 2.
Figure 2.
An example of complete response at 18FDG PET/CT during follow-up: (A) pretherapy, (B) posttherapy. FDG, 18-fluorodeoxyglucose positron emission tomography–computed tomography.
Figure 3.
Figure 3.
Kaplan-Meier curves grouping based on stage of disease II versus III: (A) overall survival, (b) local control.
See this image and copyright information in PMC

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