Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer


Background: For more than 80 years, the standard treatment of locally advanced cervical cancer wasradiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrentcisplatin-based chemoradiotherapy is the current standard for this disease. Gemcitabine has potentradiosensitizing properties in preclinical and clinical trials, so it can be utilized simultanously with radiation.Materials and
Methods: Thirty women with untreated invasive squamous cell carcinoma of the cervix of stageIIB to stage IVA were enrolled in the study in the Radiation Oncology Department of Imam Khomeini Hospitalin Tehran from September 2009 to September 2010. Sixty mg/m2 gemcitabine followed by 35mg/m2 cisplatinwere concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment weekfor five weeks. One and three months after treatment, patients underwent a complete physical examination andMRI to determine the response to treatment.
Results: The mean age of patients was 58.1±11.8 (29-78) years.After 3 months of treatment, 73.3%had complete and 26.7% demonstrated partial response to treatment. Grade3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients.
Conclusions: According to the positive results of this study in stage IIB, further phase II and III clinical trialsare suggested to evaluate the role of chemoradiation using Gemcitabine for advanced cervical cancers.