Concomitant Cisplatin and 5-Fluorouracil and Pelvic Irradiation Concomitant 5-Fluorouracil (5-FU) and Cisplatin in Locally Advanced Cervical Cancer

The aim of this study was to determine the effectiveness, feasibility and toxicity of concomitant 5-fluorouracil (5-FU) and cisplatin in locally advanced cervical cancer undergoing radiotherapy (RT). Treatment consisted of cisplatin, 5-FU and pelvic radio-therapy. Cisplatin was administered at a dose of 75 mg/m2 before radiotherapy initiation and 5-FU at a dose of 1000 mg/m2 from day two to day five of each course. Radiation was administered to the pelvis in five-day courses at a dose of 1.8 Gy daily every 40 days until a medium dose of 50.4 Gy was reached. Fifteen Gy more were administered to involved parametrium or central tumor by external radiotherapy or brachytherapy. The irradiated zone was extended to include paraaortic lymph nodes if necessary. The same schedule was repeated after three weeks. Twenty-five patients were enrolled with a median a follow-up of 36 months. 5-FU escalation to 1000 mg/m2/day was well tolerated. Toxicity consisted of grade 2 to 3 hematologic toxicity in eight patients (32%) and nausea and vomiting is mild, but grade 3 in only four patients. The overall response rate was 80% (76% complete, 4% partial). Concomitant continuous infusion 5-FU, cisplatin and pelvic radiotherapy is well tolerated. The effectiveness of our study is relatively fair. But the more cases and long-term follow-up is required to determine its impact on long-term survival.