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http://dx.doi.org/10.7314/APJCP.2013.14.9.5385

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer  

Hashemi, Farnaz Amouzegar (Department of Radiation Oncology, Tehran University of Medical Sciences)
Akbari, Ehsan Hamed (Department of Radiation Oncology, Tehran University of Medical Sciences)
Kalaghchi, Bita (Department of Radiation Oncology, Tehran University of Medical Sciences)
Esmati, Ebrahim (Department of Radiation Oncology, Tehran University of Medical Sciences)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.14, no.9, 2013 , pp. 5385-5389 More about this Journal
Abstract
Background: For more than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultanously with radiation. Materials and Methods: Thirty women with untreated invasive squamous cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in the Radiation Oncology Department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty $mg/m^2$ gemcitabine followed by $35mg/m^2$ cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks. One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment. Results: The mean age of patients was $58.1{\pm}11.8$ (29-78) years. After 3 months of treatment, 73.3%had complete and 26.7% demonstrated partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients. Conclusions: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation using Gemcitabine for advanced cervical cancers.
Keywords
Cervical cancer; gemcitabine; radiotherapy;
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1 Aghili M, Andalib B, Amouzegar Hashemi F, et al (2010). Concurrent chemo-brachytherapy with cisplatin and intracavitary brachytherapy in locally advanced uterine cervical cancer basic. Clin Cancer Res, 2, 45-52.
2 Alvarez AM, Mickiewicz E, Roth B, et al (2001). Feasibility of accelerated radiotherapy (RT) concurrent with low dose biweekly gemcitabine (G) and cisplatin (C) in locally advanced cervical carcinoma (LACC). Proc Am Soc Clin Oncol, 20, 2150.
3 Brunner TB, Grabennauer GG, Klein P, et al (2003). Phase I trial of strictly time-scheduled gemcitabine and cisplatin with concurrent radiotherapy in patients with locally advanced pancreatic cancer. Int J Rad Oncol, 551, 144-53.
4 Alvarez AM, Mickiewicz E, Rodger J, et al (2002). Radiotherapy (RT) with low dose biweekly gemcitabine (LDBG) and cisplatin in locally advanced cervical carcinoma (LACC): (stages IIa-IVa). Proc Am Soc Clin Oncol, 21, 892.
5 Amouzegar Hashemi F, Zahedi F, Farhan F, et al (2009).Medium dose rate brachytherapy for patients with cervical carcinoma; early results of a prospective trial. Tehran Uni Med J, 66, 888-93.
6 Brunner T, Grabenbauer G, Kastl S, et al (2000). A phase I trial of simultaneous gemcitabine (GEM)/cisplatin (CDDP) and radiotherapy (RT) for patients (PTS) with locally advanced pancreatic adenocarcinoma (PAC). Proc Am Soc Clin Oncol, 19, 284.
7 Duenas-Gonzales A, Cetina L, Mariscal I, et al (2003). Modern management of locally advanced cervical carcinoma. Cancer Treat Rev, 29, 389-99.   DOI   ScienceOn
8 Duenaz-Gonzalez A, Zarba JJ, Patel F, et al (2011). Phase III, open-label, randomized study comparing concurrent gemcitabine and cisplatin and radiation followed by adjuvant gemcitabine and cisplatin versus concurrent cisplstin and radiation inpatients with stage IIB to IV carcinoma of cervix. J Clinical Oncol, 29, 1678.   DOI   ScienceOn
9 Eifel PF, Berek JS, Thigpen JT (2001). Cancer of the cervix, vagina, and vulva, VT DeVita, S Hellman, SA Rosenberg, Editors, Cancer, principles and practice of oncology, (6th ed.), Lippincott Raven Publishers, Philadelphia, pp 1526-73.
10 Goedhals L, Bezwoda WR (1996). A phase II study of gemcitabine in advanced cervix carcinoma: final data. Proc Am Soc Clin Oncol, 15, 296.
11 McCormack M, Thomas H (2000). A phase Ib study of gemcitabine and concurrent radiotherapy in carcinoma of the cervix. Ann Oncol, 11, 396.
12 Jemal A, Murray T, Samuels A, et al (2003). Cancer statistics. CA Cancer J Clin, 531, 5-26.
13 Kanzawa F, Saijo N (1997). In vitro interaction between gemcitabine and other anticancer drugs using a novel threedimensional model. Semin Oncol, 24, 7-16.
14 Lawrence TS, Eisbruch A, Shewach DS (1997). Gemcitabinemediated radiosensitization. Semin Oncol, 24, 7-28.
15 Mohideen M, McCall A, Kamradt R (1997). Activity of gemcitabine and its radiosensitization of human cervical cancer cells. Proc Am Soc Clin Oncol, 17, 245.
16 Mousavi A, Karimi Zarchi M, Gilani MM, et al (2008). Radical hysterectomy in the elderly. World J surg Oncol, 6, 38.   DOI   ScienceOn
17 Okusaka T, Ito Y, Ueno H, et al (2004). Phase II study of radiotherapy combined with gemcitabine for locally advanced pancreatic cancer. Br J Cancer, 914, 673-7.
18 Petersson F (1998). Carcinoma of the cervix. In annual report on the results of treatments in gynecological cancer. Stockholm, Sweden: International Federation of Gynecology and Obstetrics, 29-33.
19 Porras AR, Valencia N, Bastarrachea J (2003). Weekly gemcitabine concurrently to external radiotherapy for cervical cancer stages Ib2-IVa. Proc Am Soc Clin Oncol, 22, 1987.
20 Peters WA, Liu PY, Barrett RJ, et al (2000). Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early stage cancer of the cervix. J Clin Oncol, 18, 1606-13.   DOI
21 Siegel R, Ward E, Brawley O, Lemal A (2011). Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA cancer J Clin, 61, 212.   DOI
22 Van Putten JW, Price A, van der Leest AH, et al (2003). A phase I study of gemcitabine with concurrent radiotherapy in stage III, locally advanced non-small cell lung cancer. Clin Cancer Res, 97, 2472-7.
23 Zarba JJ, Jaremtchuk AV, GonzalezJazey P, et al (2003). A phase I–II study of weekly cisplatin and gemcitabine with concurrent radiotherapy in locally advanced cervical carcinoma. Ann Oncol, 148, 1285-90.