The study of concurrent chemoradiotherapy in medium-term and advanced cervical carcinoma the uterine cervix

Objective To determine whether concurrent chemoradiotherapy(CCRT) is better than radiotherapy alone(RT) in the management of medium-term and advanced cervical carcinoma.Methods Ninty-two patients who had advanced cervical cancer in the First Affiliated Hospital of Medical College of Xi'an Jiaotong University From Jan.2006 to Jan.2007 were divided into two groups:A group:concurrent chemoradiotherapy(CCRT).B group:radiotherapy only(RT).Each patient was given radical radiotherapy with 10MV-X ray.The external radiotherapy total dose was 50 Gy.When external radiation dose reached 20Gy,the middle field was shielded by plumbum.This was followed by 192Ir high-dose-rate brachytherapy to a total dose 48 Gy in A point.In A group,patients received 2 cycles of chemotherapy in the second and fifth week.in CCRT group.Cisplatin was administered as continuous intravenous(IV) infusion at the dose of 25 mg/m2 d1～3 and 5-Fluorouracil of 350 mg/m2 d1～5.The patients of radiotherapy group only received radiotherapy with the same dose and methods as CCRT group.Results The effective rate of the A group and B group were 85.7% and 60.0% respectively with significant difference(P0.05)after a week of concurrent chemotherapy had finished.At the end of treatment,the effective rate of the A group and B group were 90.5% and 72.0% with statistical difference(P0.05).Three months after radiotherapy the effective rate in both groups were 97.6% and 80.0%,showing a significant difference(P0.05).More adverse effects were found in the A group than B group.Especially in bone marrow inhibition and reaction of digestive tract,it could be alleviated.Conclusion Concurrent chemoradiotherapy in medium-term and advanced cervical carcinoma can accelerate the speed of tumor extinction and increase curative effect.This treatment is well tolerated despite the high acute toxicity rate.