Zhao Jianguo,Yang Hao,Yu Zhilong,Suo Zhimin.Clinical effects of intensity modulated radiotherapy combined with cisplatin for patients with carcinoma of cervix[J].Chinese Journal of Radiological Medicine and Protection,2014,34(4):279-282
Clinical effects of intensity modulated radiotherapy combined with cisplatin for patients with carcinoma of cervix
Received:July 15, 2013  
DOI:10.3760/cma.j.issn.0254-5098.2014.04.010
KeyWords:Cervical cancer  Intensity-modulated radiotherapy(IMRT)  Cisplatin
FundProject:内蒙古自然科学基金(2013MS1186)
Author NameAffiliationE-mail
Zhao Jianguo Department of Radiation Oncology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China  
Yang Hao 内蒙古医科大学附属人民医院放疗科  
Yu Zhilong Department of Radiation Oncology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China Richard_yu1961269@sina.com 
Suo Zhimin Department of Radiation Oncology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China  
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Abstract::
      Objective To observe the clinical efficacy and adverse reactions of intensity modulated radiotherapy (IMRT) combined with cisplatin for patients with carcinoma of cervix. Methods One hundred patients with carcinoma of cervix were randomly divided into 2 equal groups to undergo IMRT only(IMRT group)and IMRT combined group (IMRT with cisplatin chemotherapy group), with 50 cases in each. Both groups were treated with external intensity modulated radiotherapy, with the total dose of 50 Gy, 2 Gy/fraction, 25 fractions in total, and 5 times/week. Two weeks later, internal radiotherapy followed, with the total dose of 42-48 Gy,1 time/week with 6-8 times and 6-7 Gy/fraction. When the internal radiotherapy began, the external radiotherapy stopped immediately. The combination group was treated concurrently with cisplatin given by intravenous drip once a week, at the dose of 30-40 mg/m2 body surface area for 4-5 weeks, and with total cisplatin dosage of 50-65 mg. Follow-up was conducted for 18 months(3-60 months). The 1-, 3-, and 5-year survival rates, local control rate, distant metastasis rate, and disease-free survival rate, blood test,rectum, and bladder were observed. Results The 1-year survival rate, local control rate, distant metastasis rate,and disease-free survival rate did not differ significantly between these 2 groups, however,the 3-and 5-year survival rates, local control rates, distant metastasis rates and disease-free survival rates of the combination group were all significantly better than those of the IMRT group (χ2=3.843,4.336,4.336,4.960,P<0.05; χ2=3.934,4.454,4.000,4.244, P<0.05). The incidence rates of radiation proctitis and leukopenia of the combination group were significantly higher than those of the IMRT only group (χ2=4.110,4.320, P<0.05), whereas the incidence rates of cystitis, anemia, and thrombocytopenia were not significantly different between these 2 groups. No serious grade 3-4 proctitis and cystitis were observed in these 2 groups. Conclusions The IMRT combined with cisplatin chemotherapy shows higher 3-year and 5-year long-term efficacy in the patients with carcinoma of cervix than IMRT only group.
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