دورية أكاديمية
Acute and long-term toxicity in patients undergoing induction chemotherapy followed by thermoradiotherapy for advanced cervical cancer
| العنوان: | Acute and long-term toxicity in patients undergoing induction chemotherapy followed by thermoradiotherapy for advanced cervical cancer |
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| المؤلفون: | X. S. Gao, I. A. Boere, H. J. van Beekhuizen, M. Franckena, R. Nout, M. J. H. A. Kruip, M. D. Kulawska, H. C. van Doorn |
| المصدر: | International Journal of Hyperthermia, Vol 39, Iss 1, Pp 1440-1448 (2022) |
| بيانات النشر: | Taylor & Francis Group, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Medical technology |
| مصطلحات موضوعية: | Cervical cancer, venous thrombo-embolism, induction chemotherapy, cisplatin, radiotherapy, thermoradiotherapy, Medical technology, R855-855.5 |
| الوصف: | Objectives To determine rates of vascular toxicity, acute kidney injury (AKI), chronic kidney disease (CKD) and survival in high-risk cervical cancer patients treated with platinum-based induction chemotherapy followed by thermoradiotherapy.Methods Between January 1999 and April 2017, patients with large primary tumors (>6cm) and/or para-aortic lymph node (LN) metastases >1 cm and/or para-iliac LN >2 cm were included. Patient and tumor characteristics, Common Toxicity Criteria v4.03 scores, laboratory tests and treatment data were retrieved from patient records. CT scans were reviewed for the presence of thrombo-embolic events (TEE). The study protocol was approved by the Medical Ethics Review Committee of Erasmus MC, Rotterdam (MEC2017-133).Results The 105 included patients had a mean age of 47.9 years (range 22–79) and a median follow-up time of 43 months (IQR 14–72). Median tumor size was 6.0 cm (range 2.6–11.5), 30% had a clinical FIGO stage ≥ IIIB and 42% had enlarged para-aortic LN. Cisplatin-based therapy was started in 86 patients (82%), of whom 30 (35%) switched to carboplatin and 47% of patients completed six cycles of platinum-based chemotherapy. All patients received external beam radiotherapy as planned, 98 patients (93%) underwent brachytherapy as planned or received an external boost, and 95 patients (90%) completed all five planned hyperthermia treatments. During cisplatin chemotherapy, 34 patients experienced AKI (39%). At last follow-up, 35% of patients had chronic renal toxicity (GFR 59 − 15/min/1.73 m2). At presentation, a TEE was present in 10 (10%) and another 23 (22%) patients experienced a TEE (18% venous, 4% arterial) during chemotherapy. Five-year overall survival was 58% (95% CI 47.8–68.6 SE 0.053).Conclusion Achieving a five-year overall survival of 58%, platinum-based induction chemotherapy followed by thermoradiotherapy is an effective treatment for advanced-stage high-risk cervical cancer. However, treatment is accompanied by an unacceptably high prevalence of chemotherapy-associated TEE and acute kidney injury, as well as chronic kidney disease. Future studies should investigate the role of carboplatin in reducing toxicity and the effect of thromboprophylaxis in high-risk patients. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 02656736 1464-5157 0265-6736 |
| Relation: | https://doaj.org/toc/0265-6736; https://doaj.org/toc/1464-5157 |
| DOI: | 10.1080/02656736.2022.2146213 |
| URL الوصول: | https://doaj.org/article/ea259be1138d4381b4fc460ea3662354 |
| رقم الأكسشن: | edsdoj.259be1138d4381b4fc460ea3662354 |
| قاعدة البيانات: | Directory of Open Access Journals |
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Full Text Finder | تدمد: | 02656736 14645157 |
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| DOI: | 10.1080/02656736.2022.2146213 |