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Annals of Oncology 14:298-303, 2003
© 2003 European Society for Medical Oncology

Original Paper

Phase I study of combined radiation, hyperthermia and intra-arterial carboplatin for local recurrence of cervical cancer

H. Tsuda1,2,+, M. Tanaka3, T. Manabe3, H. Ikeda3, S. Negoro2, O. Ishiko4 and K. Yamamoto1

Departments of 1 Obstetrics and Gynecology, 2 Clinical Oncology and 3 Radiation Oncology, Osaka City General Hospital; 4 Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan

Received 20 July 2001; revised 2 January 2002; accepted 3 May 2002

Background:

Patients with cervical cancer who develop pelvic recurrence after primary surgery are usually treated with radiation-based therapy. However, their prognoses are dismal. We conducted a phase I study of combined radiation, hyperthermia and intra-arterial (IA) carboplatin for local recurrence of cervical cancer.

Patients and methods:

Patients with local recurrence of cervical cancer without extrapelvic recurrence were included in this study. Carboplatin was given as a 5-min IA infusion without hydration just before pelvic radiation every day. External pelvic irradiation (1.8 Gy/day for 28 days) was performed according to local standard schedules. After 20 Gy had been administered, hyperthermia was performed once a week with a radio frequency heating system for four cycles.

Results:

Fifteen patients were entered through the four dose levels of carboplatin. The maximum tolerated dose was determined to be 25 mg/m2 and the dose-limiting toxicities were leukocytopenia, neutrocytopenia and diarrhea. Grade 3/4 leukocytopenia and diarrhea were observed in nine (60%) and three (20%) of 15 patients. Tumor responses included five complete responses and nine partial responses, and the overall response rate was 93.3% (14 of 15) (95% confidence interval 59.4% to 100%). Tumor reductions were observed only at 20 Gy in 10 cases of 14 responders (71.4%).

Conclusion:

The combination therapy of radiation, hyperthermia and IA carboplatin is safe and well-tolerated for locally recurrent cervical cancer.

Key words: carboplatin, cervical cancer, chemoradiation, hyperthermia, recurrence


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