Clinical randomized study of concurrent radiotherapy and chemotherapy with local advanced cervical cancer

Objective To study two different methods of radiotherapy and their side-effects in treating local advanced cervical cancer.Methods Eligible patients with stage Ⅱ a ～ Ⅲb cervical cancer were randomly divided into the study group and the control group.The patients in the study group were irradiated to 45 Gy/22 fractions at primary lesions and 50 Gy/22 fractions at lymphatic drainage using IMRT followed by high-dose rate (HDR) brachytherapy (36 Gy/6 fractions).The control group had the same target range sizes as the study group,and the patients were irradiated to 45 Gy/22 fractions at pelvic cavity and additional 6 Gy/3 fractions at pelvic wall using four-field cassette technique followed by highdose rate (HDR) brachytherapy (36/6 fractions).Both groups were treated with concurrent chemotherapy,by nedaplatin 30 mg/m2 weekly for a total of 6 cycles.Results Between Sep 2006 and Sep 2009,72 patients were enrolled into the study,and 36 cases were assigned in the study group and 36 cases in the control group.Nausea and vomiting,decline of hemoglobin and neutrophil were similar in two groups.Grade Ⅲ diarrhea in the study group and the control group was 5.6％ and 30.6％,respectively,with significant difference in diarrhea.1-,2-and 3-year overall survival rates of the study group were 94.4％,86.1％,77.8％,and 1-,2-and 3-year disease-free survival rate were 91.7％,75.0％,72.2％ in the study group.and 1-,2-and 3-year overall survival rate were 91.7％,86.1％,75.0％,and 1-,2-and 3-year disease-free survival rate were 91.7％,72.2％,69.4％ in the control group,respectively.There were no significant differences for overall survival and disease-free survival between two groups.Conclusions Intensity modulated radiation therapy with cervical cancer can reduce significantly the rate of acute proctitis.Overall survival and disease-free survival might be similar in two groups. Key words: Cervical cancer;  Intensity-modulated radiotherapy;  Toxicity;  Clinical efficacy