The role of raltitrexed/cisplatin with concurrent radiation therapy in treating advanced cervical cancer

OBJECTIVE: To explore the effectiveness and safety of raltitrexed/cisplatin with concurrent radiotherapy in treating of patients with advanced cervical cancer. PATIENTS AND METHODS: Sixty-five patients with stage IIB-IVA cervical cancer enrolled in this study, received raltitrexed/cisplatin with concurrent radiotherapy. The treatment consisted of raltitrexed 3 mg/m(2) iv 15 min, d1; cisplatin 60 mg/m(2) iv 60 min, d1, and pelvic radiotherapy, using three-dimensional conformal radiotherapy. The radiotherapy was implemented over Elekta accelerator (Model Type Precise), with 2.0 Gy per fraction for the whole pelvic or pelvic extension field. Central lead shield was used if the dose reached 30 Gy to produce a total dosage of 50 Gy. Following radiation therapies of full pelvic field or extended-field, additional radiation with the dose of 56-60 Gy was administrated to the lymph node metastases. Brachytherapy of iridium 192 was completed in our hospital, with the dose of 7Gy per fraction for point A, once a week, with six fractions for internal radiations during the full treatment course of eight weeks. RESULTS: A total of 65 patients completed radiotherapy with two cycles of concurrent chemotherapy. Amongst them, chemotherapy was delayed for a week due to hypoleukocytosis for seven of the patients. Total response rate, three-year disease-free survival, and three-year overall survival OS were 95.4%, 75.4%, and 90.7%. High-grade (>= 3) acute toxicities were hypoleukocytosis (23.1%) and thrombocytopenia (6.2%) with a prevalence of high-grade (>= 3) late toxicities at 1.5%. One patient received surgical resection because of a partial intestinal obstruction after 8 months of radiotherapy. CONCLUSIONS: Raltitrexed/cisplatin combined with concurrent radiotherapy is effective in treating advanced cervical cancer.