Concomitant chemoradiotherapy for advanced epidermoid carcinoma of the uterine cervix: a preliminary report.

BACKGROUND: Because the prognosis of advanced carcinoma of the uterine cervix is poor, and has improved very little in the last 20 years, a prospective study was initiated to evaluate the feasibility, response and toxicities of concomitant chemoradiotherapy for such cervical cancer. METHODS: From May 1992 to December 1992, 22 patients entered the study, 21 of them completed the entire treatment. Their ages ranged from 47 to 72 years, median 57. There were 16 FIGO stage IIIB, and 5 stage IIB. Radiotherapy was administered using 1.8 Gy/day, five days a week, to the whole pelvis (50.4 Gy/28 fractions) with or without parametrial boost according to the tumor response. Intracavitary brachytherapy 5 Gy x five to six times was given after one or two weeks of rest. Chemotherapy consisted of etoposide 100 mg/m2 day 1 + cisplatin 50 mg/m2 day 1 + bleomycin 25 mg/m2/day day 2-3, repeated every two weeks during external irradiation. RESULTS: All 21 eligible patients achieved complete response, sustaining during a median follow-up time of 12 months. All the initially elevated tumor markers (SCC, CEA, CA-125) returned to normal range after treatment. The toxicity was well tolerated. CONCLUSIONS: Concomitant chemoradiotherapy for advanced cervical carcinoma is both feasible and effective, with acceptable toxicities. Long-term follow-up is mandatory, and a randomized trial to confirm the superiority of this protocol will be started soon.