Definitive Concurrent Chemoradiotherapy in Cervical Cancer - a University of Malaya Medical Centre Experience

Background: The efficacy of concurrent chemoradiotherapy in the treatment of locally advanced cervical canceris well established. We aimed to investigate the long-term efficacy of definitive concurrent chemoradiotherapyfor cervical cancer in the University of Malaya Medical Centre. Materials and
Methods: A cohort of 60 patientswith FIGO stage IB2-IVA cervical cancer who were treated with definitive concurrent chemoradiotherapywith cisplatin followed by intracavitary brachytherapy or external beam radiotherapy (EBRT) boost betweenNovember 2001 and May 2008 were analysed. Patients were initially treated with weekly intravenous cisplatin(40mg/m2) concurrent with daily EBRT to pelvis of 45-50Gy followed by low dose rate brachytherapy or EBRTboost to tumour. Local control rate, progression free survival, overall survival and treatment related toxicitiesgraded by the RTOG criteria were evaluated.
Results: The mean age was 56. At the median follow-up of 72months, the estimated 5-year progression-free survival (PFS) (median PFS 39 months) and the 5-year overallsurvival (OS) (median OS 51 months) were 48% and 50% respectively. The 5-year local control rate was 67.3%.Grade 3-4 late gastrointestinal and genitourinary toxicity occurred in 9.3% of patients.
Conclusions: The 5-yearPFS and the 5-year OS in this cohort were lower than in other institutions. More advanced stage at presentation,longer overall treatment time (OTT) of more than fifty-six days and lower total dose to point A were the potentialfactors contributing to a lower survival.