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Serviks Uteri Kanseri Tedavisinde Eş Zamanlı Kemoradyoterapi ve Yalnız Radyoterapinin Tedaviye Yanıt ve Akut Toksisite Açısından Karşılaştırılması

Yıl 2010, Cilt: 43 Sayı: 2, 2 - 3, 01.08.2010

Öz

Introduction: To assess treatment response, feasibility, safety and effectiveness of radiotherapy by different regimens of HDRbrachytherapy and external beam radiotherapy (EBRT) with and without concurrent cisplatin in the treatment of advanced cervical cancer. Patients and Methods: A total of 95 patients with advanced cervical cancer were included for analysis. All patients were divided to 3 groups. In the I group we used EBRT in total dose 46-50 Gy, HDRBt - four 7.5 Gy weekly fractions. II group patients received 46-50 Gy EBRT, two weekly 9.0 Gy HDRBT fractions. In the III group we carried out the same radiotherapy regimen plus concorrent cisplatin (40 mg/m2 of body surface per week for five weeks). Results: All patients completed radiotherapy as planned and in the III group 96% patients received at least four cycles chemotherapy. Complete response (CR) was obtained at 88.8%, 90%, 96.6% patients in I, II, III groups correspondingly. Treatment related toxicity (particularly hematological) which was assessed according to CTC RTOG scale was significantly higher in the HI group. Conclusion: EBRT, HDRBt plus cisplatin appears to be safe and effective, although acute hematological toxicity is increased but appears to be acceptable.

Kaynakça

  • Davidov MI, Kuznetsov VV, Nechushkina VM. Lectures on Oncogynecotogy 2009:199.
  • Ferlay J, Bray F, Pisani P, et al. Globocan 2002: Cancer In- cidence, Mortality and Prevalence Worlfwide-IARC Cancer- Base N5, v. 2.0.-Lyon: İARC Press, 2004.
  • Jemal D, Siegel M, Ward D, et al. Cancer Statistics, 2006. C.A. Cancer J Clin. 2006; 56:106-30. 4
  • Green J, Kirwan J, Tierney J, Vale C, Symonds P, Fresco L,
  • et al. Concomitant chemotherapy and radiation therapy for cancer of the uterine cervix (Review). The Cochrane Library 2008, Issue 4.
  • Asgarov NM, Guliyev EG, Huseynov RR. Raditherapy of cer­ vical cancer, Azerbaijan Oncology and Hematology Journal. 2007; 72-75.
  • Kostromina KN, Razumova EL, Korotkikh NV. Methodology of combined radiotherapy of advanced cervical cancer in con- dition of Chemical polyradiomodification. Modern Oncology. 2004; 6.
  • Lucely Cetina, et al. Routine management of locaily advanced cervical cancer vvith concurrent radiation and cisplatin. Five- year results. BMC Women’s Health 2006.

Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone

Yıl 2010, Cilt: 43 Sayı: 2, 2 - 3, 01.08.2010

Öz

İleri evre serviks kanseri tedavisinde yüksek doz oranlı brakiterapi (HDR-brakiterapi) ve dıştan odaklamalı radyoterapi (external beam radiotherapy) rejimlerinin tek başına ve eş zamanlı sisplatin kemoterapisi ile uygulandığında uygulanabilirlik, güvenlik, tedaviye yanıt ve etkinlik açısından karşılaştırılması. Hastalar ve Yöntem: İleri evre serviks kanseri olan toplam 95 hasta incelemeye dahil edildi. Hastalar 119 gruba ayrıldı. Birinci gruptaki hastalara total doz 46-50 Gy olacak şekilde dıştan odaklamalı radyoterapi (external beam radiotherapy), yüksek doz oranlı brakiterapi (HDR-brakiterapi)-7.5 Gy'lik dörde bölünmüş haftalık fraksiyonlar halinde uygulandı. İkinci gruptaki hastalar 46-50 Gy dıştan odaklamalı radyoterapi (external beam radiotherapy), iki haftalık 9.0 Gy yüksek doz oranlı brakiterapi (HDR-brakiterapi) aldı. Üçüncü gruptaki hastalara ise aynı radyoterapi rejimleri ile birlikte eş zamanlı sisplatin (haftalık 40 mg/m2 beş hafta boyunca) kemoterapisi uygulandı. Bulgular: Bütün hastalar planlanan radyoterapiyi aldı ve üçüncü gruptaki hastaların da %96'sı en az dört siklus kemoterapi aldı. Tam yanıt oranları Grup l, Grup 2 ve Grup 3'te sırasıyla %88.8, %90 ve %96.6 olarak tespit edildi. Tedavi ile ilişkili toksisite (özellikle hematolojik) CTC RTOG Skalası ile değerlendirildi ve Grup 3'te belirgin olarak yüksekti. Sonuç: Dıştan odaklamalı radyoterapi (external beam radiotherapy) ve yüksek doz oranlı brakiterapi (HDR-brakiterapi)'nin sisplatin ile eş zamanlı uygulandığında akut hematolojik toksisitedeki kabul edilebilir artışa rağmen güvenli ve etkin görünmektedir.

Kaynakça

  • Davidov MI, Kuznetsov VV, Nechushkina VM. Lectures on Oncogynecotogy 2009:199.
  • Ferlay J, Bray F, Pisani P, et al. Globocan 2002: Cancer In- cidence, Mortality and Prevalence Worlfwide-IARC Cancer- Base N5, v. 2.0.-Lyon: İARC Press, 2004.
  • Jemal D, Siegel M, Ward D, et al. Cancer Statistics, 2006. C.A. Cancer J Clin. 2006; 56:106-30. 4
  • Green J, Kirwan J, Tierney J, Vale C, Symonds P, Fresco L,
  • et al. Concomitant chemotherapy and radiation therapy for cancer of the uterine cervix (Review). The Cochrane Library 2008, Issue 4.
  • Asgarov NM, Guliyev EG, Huseynov RR. Raditherapy of cer­ vical cancer, Azerbaijan Oncology and Hematology Journal. 2007; 72-75.
  • Kostromina KN, Razumova EL, Korotkikh NV. Methodology of combined radiotherapy of advanced cervical cancer in con- dition of Chemical polyradiomodification. Modern Oncology. 2004; 6.
  • Lucely Cetina, et al. Routine management of locaily advanced cervical cancer vvith concurrent radiation and cisplatin. Five- year results. BMC Women’s Health 2006.
Toplam 8 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Kamal S Akbarov Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 43 Sayı: 2

Kaynak Göster

APA Akbarov, K. S. . (2010). Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone. Acta Oncologica Turcica, 43(2), 2-3.
AMA Akbarov KS. Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone. Acta Oncologica Turcica. Ağustos 2010;43(2):2-3.
Chicago Akbarov, Kamal S. “Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison With Radiotherapy Alone”. Acta Oncologica Turcica 43, sy. 2 (Ağustos 2010): 2-3.
EndNote Akbarov KS (01 Ağustos 2010) Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone. Acta Oncologica Turcica 43 2 2–3.
IEEE K. S. . Akbarov, “Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone”, Acta Oncologica Turcica, c. 43, sy. 2, ss. 2–3, 2010.
ISNAD Akbarov, Kamal S. “Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison With Radiotherapy Alone”. Acta Oncologica Turcica 43/2 (Ağustos 2010), 2-3.
JAMA Akbarov KS. Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone. Acta Oncologica Turcica. 2010;43:2–3.
MLA Akbarov, Kamal S. “Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison With Radiotherapy Alone”. Acta Oncologica Turcica, c. 43, sy. 2, 2010, ss. 2-3.
Vancouver Akbarov KS. Treatment Response and Acute Toxicity of Concurrent Chemoradiotherapy for Uterine Cervix Cancer in Comparison with Radiotherapy Alone. Acta Oncologica Turcica. 2010;43(2):2-3.