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| |  DG DISPATCH - ASTRO: Late After-effects For Cervical-cancer Patients Treated With Combination Therapy By Maria Bishop Special to DG News
BOSTON, MA -- October 27, 2000 -- Patients who received chemoradiation to treat cervical cancer are likely to see a high rate of after-effects years later, noted United States researchers at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Boston, MA. Late toxicity was analysed in a retrospective study of 72 patients with locally advanced cervical cancer who had all been treated with radiotherapy and concurrent chemotherapy with 5-fluorouracil (5-FU) and mitomycin-C at a single institution between 1983 and 1990. The lead investigator for this study was Dr. Maria D. Kelly of the medicine-radiation/oncology department, University of Virginia, Charlottesville, Virginia. The end points of the analyses in this study were survival, local control and toxicity. Patients were followed for a minimum of five-years or until death, allowing the researchers to specifically examine the incidence of delayed toxicity. Five-year determinate survival was available in 60 patients. Survival was 42 percent for patients with all stages of disease, collectively. Local control was achieved in 68 percent of patients, through the use of chemoradiation. Researchers noted that delayed toxicity was observed in 22 patients, with gastrointestinal, urologic and vascular aftereffects comprising the majority of observed effects. Significant late toxicity effects were observed in an absolute 38 percent of patients (42 percent as an actuarial rate). Actuarial rates of severe late toxicity for gastrointestinal, urological and vascular after-effects were 29 percent, 38 percent and 33 percent, respectively, at five years. The research team concluded that an unusually high rate of late sequelae is seen in long-term survivors of locally advanced cervical cancer treated with 5-FU, mitomycin C and radiotherapy concurrently. It remains to be seen whether these late effects occur in the setting of current cisplatin-based chemoradiation, noted Dr. Kelly. Recent results from each of five, randomized, phase-III trials show an overall survival advantage for cisplatin-based therapy given concurrently with radiation therapy. Cervical cancer is one of the most common cancers, accounting for 6 percent of all malignancies in women.
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