Safety And Short-Term Effect Of Docetaxel And Cisplatin Chemotherapy Concurrent With Pelvic Radiation Therapy In Cervical Cancer

To decrease the metastasis and improve survival of cervical cancer, docetaxel and cisplatin regimen were used concurrent with radiation therapy in selected post-operative and locally advanced cervical cancer patients. The safety and short-term effect of TP tri-weekly regimen were evaluated compared with cisplatin weekly regimen in this prospective clinical study. A total of 235 patients with cervical cancer from Oct 2013 to Apr 2015 were included in this study. The inclusion criterions: (1) confirmed cervical cancer by pathology; (2) 18 to 70 years old and KPS score ≥70; (3) no severe systemic disease or contraindications which may affect chemo-radiation. The post-operative patients should be with high-risk factors (positive pelvic lymph node, parametria invasion, and positive vaginal margins). The tumor diameter should be smaller than 6cm in LACC. All the patients accepted the whole pelvic radiation by 3D-CRT and concurrent chemotherapy. Brachytherapy was used in post-operative patient with positive vaginal margin and LACC. According to the different chemotherapy regimens, patients were divided into two groups: (1) control group, the regimen was cisplatin weekly (40mg/m2); (2) study group, the regimen were docetaxel (60mg/m2) and cisplatin (60mg/m2) tri-weekly. The safety and short-term effect were evaluated at the end of radiation. A total of 76 patients were divided into control group and 159 patients were in study group. During the chemo-radiation time, the severe gastro-intestinal reaction was higher in study group than control group, although the difference was not significant (16.4% vs. 9.2%, P = 0.286). and the frequency of grade 3-4 hematologic toxicity were 28.3% and 22.4% in two groups respectively, and the difference was not significant, P = 0.745). Of the 129 LACC patients, 46 cases accepted the cisplatin weekly chemotherapy regimen and 83 patients received TP tri-weekly regimen. At the end of whole pelvic irradiation, the total response and complete response rate were 87.8% and 31.3% in control group, and 90.6% and 39.2% in study group, respectively. In addition, the difference was not significant (P = 0.514). Compared with the cisplatin weekly concurrent chemotherapy, radiation combined with chemotherapy of TP regimen maybe acquire a better short-term response and do not show an unaccepted toxicity. This result should be confirmed by this prospective study.