Serviks Uteri Kanseri Tedavisinde Eþ Zamanlý Kemoradyoterapi ve Yalnýz Radyoterapinin Tedaviye Yanýt ve Akut Toksisite Açýsýndan Karþýlaþtýrýlmasý

Introduction: To assess treatment response, feasibility, safety and effectiveness of radiotherapy by different regimens of HDRbrachytherapy and external beam radiotherapy (EBRT) with and without concurrent cisplatin in the treatment of advanced cervical cancer. Patients and Methods: A total of 95 patients with advanced cervical cancer were included for analysis. All patients were divided to 3 groups. In the I group we used EBRT in total dose 46-50 Gy, HDRBt - four 7.5 Gy weekly fractions. II group patients received 46-50 Gy EBRT, two weekly 9.0 Gy HDRBT fractions. In the III group we carried out the same radiotherapy regimen plus concorrent cisplatin (40 mg/m2 of body surface per week for five weeks). Results: All patients completed radiotherapy as planned and in the III group 96% patients received at least four cycles chemotherapy. Complete response (CR) was obtained at 88.8%, 90%, 96.6% patients in I, II, III groups correspondingly. Treatment related toxicity (particularly hematological) which was assessed according to CTC RTOG scale was significantly higher in the HI group. Conclusion: EBRT, HDRBt plus cisplatin appears to be safe and effective, although acute hematological toxicity is increased but appears to be acceptable.

Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone

Ýleri evre serviks kanseri tedavisinde yüksek doz oranlý brakiterapi (HDR-brakiterapi) ve dýþtan odaklamalý radyoterapi (external beam radiotherapy) rejimlerinin tek baþýna ve eþ zamanlý sisplatin kemoterapisi ile uygulandýðýnda uygulanabilirlik, güvenlik, tedaviye yanýt ve etkinlik açýsýndan karþýlaþtýrýlmasý. Hastalar ve Yöntem: Ýleri evre serviks kanseri olan toplam 95 hasta incelemeye dahil edildi. Hastalar 119 gruba ayrýldý. Birinci gruptaki hastalara total doz 46-50 Gy olacak þekilde dýþtan odaklamalý radyoterapi (external beam radiotherapy), yüksek doz oranlý brakiterapi (HDR-brakiterapi)-7.5 Gy’lik dörde bölünmüþ haftalýk fraksiyonlar halinde uygulandý. Ýkinci gruptaki hastalar 46-50 Gy dýþtan odaklamalý radyoterapi (external beam radiotherapy), iki haftalýk 9.0 Gy yüksek doz oranlý brakiterapi (HDR-brakiterapi) aldý. Üçüncü gruptaki hastalara ise ayný radyoterapi rejimleri ile birlikte eþ zamanlý sisplatin (haftalýk 40 mg/m2 beþ hafta boyunca) kemoterapisi uygulandý. Bulgular: Bütün hastalar planlanan radyoterapiyi aldý ve üçüncü gruptaki hastalarýn da %96’sý en az dört siklus kemoterapi aldý. Tam yanýt oranlarý Grup l, Grup 2 ve Grup 3’te sýrasýyla %88.8, %90 ve %96.6 olarak tespit edildi. Tedavi ile iliþkili toksisite (özellikle hematolojik) CTC RTOG Skalasý ile deðerlendirildi ve Grup 3’te belirgin olarak yüksekti. Sonuç: Dýþtan odaklamalý radyoterapi (external beam radiotherapy) ve yüksek doz oranlý brakiterapi (HDR-brakiterapi)’nin sisplatin ile eþ zamanlý uygulandýðýnda akut hematolojik toksisitedeki kabul edilebilir artýþa raðmen güvenli ve etkin görünmektedir.