DOI QR코드

DOI QR Code

Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study

  • Kumaran, Aswathy (Department of Obstetrics Gynecology, Kasturba Medical College) ;
  • Guruvare, Shyamala (Department of Obstetrics Gynecology, Kasturba Medical College) ;
  • Sharan, Krishna (Department of Radiation Oncology, Kasturba Medical College) ;
  • Rai, Lavanya (Department of Obstetrics Gynecology, Kasturba Medical College) ;
  • Hebbar, Shripad (Department of Obstetrics Gynecology, Kasturba Medical College)
  • 발행 : 2014.06.15

초록

Purpose: To assess chemoradiation related acute morbidity in women with carcinoma cervix and to find and correlation between hematologic toxicity and organ system specific damage. Materials and Methods: A prospective study was carried out between August 2012 and July 2013 enrolling 79 women with cancer cervix receiving chemo-radiotherapy. Weekly assessment of acute morbidity was done using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4 and the toxicities were graded. Results: Anemia [77 (97.5%)], vomiting [75 (94.8%)] and diarrhea [72 (91.1%)], leukopenia [11 (13.9%)], cystitis [28 (35.4%], dermatitis [19 (24.1%)] and fatigue [29 (36.71%)] were the acute toxicities noted. The toxicities were most severe in $3^{rd}$ and $5^{th}$ week. All women could complete radiotherapy except two due to causes unrelated to radiation morbidity; seven (8.86%) had to discontinue chemotherapy due to leukopenia and intractable diarrhea. Though there was no correlation between anemia and other toxicities, it was found that all with leukopenia had diarrhea. Conclusions: Chemoradiation for cancer cervix is on the whole well tolerated. Leukopenia and severe diarrhea were the acute toxicities that compelled discontinuation of chemotherapy in two women. Though anemia had no correlation with gastrointestinal toxicity, all of those with leukopenia had diarrhea.

참고문헌

  1. Amouzegar-Hashemi F, Akbari EH, Kalaghchi B, Esmati E (2013). Concurrent chemoradiation with weekly gemcitabine and cisplatin for locally advanced cervical cancer. Asian Pac J Cancer Prev, 14, 5385-9. https://doi.org/10.7314/APJCP.2013.14.9.5385
  2. Bhavaraju VMK, Reed NS, Habeshaw T (2004). Acute toxicity of concomitant treatment of chemoradiation with single agent cisplatin in patients with carcinoma of the cervix. Thai J Physiol Sci, 17, 90-7.
  3. Green JA, Kirwan JM, Tierney JF, et al (2001). Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and meta-analysis. Lancet, 358, 781-6. https://doi.org/10.1016/S0140-6736(01)05965-7
  4. Gunawan R, Nuranna L, Supriana N, Sutrisna B, Nuryanto KH (2012). Acute toxicity and outcomes of radiation alone versus concurrent chemoradiation for locoregional advanced stage cervical cancer Indones. J Obstet Gynecol, 36, 37-42.
  5. Hu Y, Cai Z, Su X (2012). Concurrent weekly cisplatin versus triweekly cisplatin with radiotherapy in the treatment of cervical cancer: a meta-analysis result. Asian Pac J Cancer Prev, 13, 4301-4. https://doi.org/10.7314/APJCP.2012.13.9.4301
  6. Ikushima H, Osaki K, Furutani S, et al (2006). Chemoradiation Therapy for Cervical Cancer: Toxicity of concurrent weekly Cisplatin. J Radiation Med, 24, 115-21. https://doi.org/10.1007/BF02493277
  7. Karnofsky DA, Burchenal JH (1949). The Clinical Evaluation of Chemotherapeutic Agents in Cancer. In: MacLeod CM (Ed), Evaluation of Chemotherapeutic Agents. Columbia Univ Press. Page 196.
  8. Khalid M, Hussain SI, Kanwal T, Nadeem K (2012). Toxicity profile in cervical cancer patients receiving chemoradiation with concurrent parametrial boost. APMC, 6, 9-12.
  9. Maduro JH, Pras E, Willemse PH, De Vries EG (2003). Acute and long-term toxicity following radiotherapy alone or in combination with chemotherapy for locally advanced cervical cancer. Cancer Treat Rev, 29, 471-88. https://doi.org/10.1016/S0305-7372(03)00117-8
  10. Mahantshetty UM, Shrivastava S, Roy D, et al (2010). Concomitant chemoradiation in advanced stage carcinoma cervix: A phase III randomised trial. (CRACX Study- NCT 00193791). Int J Radiation Oncol, 78, 141.
  11. National Cancer Institute Common Terminology Criteria for Adverse Events v4.0 (2009). NCI, NIH, DHHS.NIH publication # 09-7473.
  12. Rose P, Bundy B, Watskins E (1999). Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cancer. N Engl J Med, 340, 1144-53. https://doi.org/10.1056/NEJM199904153401502
  13. Tan LT, Russell S, Burgess L (2004). Acute toxicity of chemo-radiotherapy for cervical cancer: the Addenbrooke's experience. J Clin Oncol, 16, 255-60. https://doi.org/10.1016/j.clon.2003.12.004
  14. Yuenyao P, Chumworathayi B, Luanratanakorn S, et al (2007). Hematologic toxicities of cisplatin concurrent chemoradiation in cervical cancer at Ubonrajchathani Cancer Center. Srinagarind Med J, 22, 127-32.

피인용 문헌

  1. Impact of Treatment Time on Chemoradiotherapy in Locally Advanced Cervical Carcinoma vol.16, pp.12, 2015, https://doi.org/10.7314/APJCP.2015.16.12.5075
  2. High Dose Rate Brachytherapy in Two 9 Gy Fractions in the Treatment of Locally Advanced Cervical Cancer - a South Indian Institutional Experience vol.16, pp.16, 2015, https://doi.org/10.7314/APJCP.2015.16.16.7167
  3. Assessing Activity Limitation Among Cancer Survivors in Korea Using Data from a Nationwide Survey vol.16, pp.7, 2015, https://doi.org/10.7314/APJCP.2015.16.7.2739
  4. Acute radiation toxicity during and after concurrent chemoradiotherapy in patients with localy advanced cervical cancer vol.10, pp.2, 2018, https://doi.org/10.5937/racter10-18049