Treatment Interruption During Concurrent Chemoradiotherapy of Uterine Cervical Cancer; Analysis of Factors and Outcomes

Background: To evaluate factors which effect treatment interruption during concurrent chemoradiotherapy(CCRT) and overall survival in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital.Materials and
Methods: Between January 2006 and December 2007, 107 patients with stage IB2-IVA as FIGOstaging, 2000, were treated with CCRT in Srinagarind Hospital. Factors which caused treatment interruptionsand impacted on overall survival were reviewed and analyzed.
Results: Twenty of 107 patients had treatmentinterruption during CCRT in patients with uterine cervical cancer stage IB2-IVA in Srinagarind Hospital. Thecauses of treatment interruption were as follows: hematologic toxicity was found in 16 of 20 cases, 12 cases withgrade 2 and 4 cases with grade 3; three of 20 cases had gastrointestinal toxicities, 1 case with grade 2 and 2cases with grade 3; one case had grade 3 skin toxicity. The mean total treatment time of the uninterrupted andinterrupted groups were significantly different (78.98 days vs 161.80 days, p <0.001). The patients who couldtolerate≥5 cycles of cisplatin administration had significantly higher mean white blood counts (WBC) (9,769 cells/mm3 vs 7,141 cells/mm3, p=0.02). The mean initial hemoglobin (Hb) in the uninterrupted group was significantlyhigher than the interrupted group (11.5 mg% vs 10.3 mg%, p=0.03). Other factors including age, KPS, initialplatelets, initial serum creatinine levels showed no statistical significance. The 3-year overall survival of theuninterrupted group was better than in the interrupted group (78.6% vs 55.0%, p=0.03).
Conclusions: Theinitial Hb and WBC levels were significantly correlated with treatment interruption during CCRT in patientswith uterine cervical cancer. The 3-year overall survival of the uninterrupted group was significantly better thaninterrupted group. These factors may then be used indirectly to predict the outcomes of treatment.