ABSTRACT
This study aimed to evaluate the effect of concomitant radiotherapy with weekly paclitaxel as radiosensitizer in locally advanced cervical cancer on response rate, progression free survival and overall survival. In addition to evaluate the pattern of toxicity with this treatment regimen.Between June 2001 and December 2002, seventeen women with histopathologically proven squamous cell carcinoma of the uterine cervix, stages IIB, III and IVA were recruited in this study. Patients were treated with whole pelvis external beam radiotherapy 45 GY with 1.8 Gy/fraction administered five days a week concurrent with paclitaxel 50 ing/m2 administered in weekly basis. This was followed one to two weeks later with single intracavitary Cs137 insertion aiming at 30 Gy to point A and then parametrial boost [5-6 Gy] according to disease extension. Response to treatment, toxicity profile, 18-month disease free and overall survival were estimated. The median age of the patients was 56 years. The majority of patients had FIG0 stage IIIB [52.9%]. The most common histological grade was grade II [58.8%]]. The median tumor size was 5.4 cm [range 3-11 cm]. Bilateral parametrial involvement was encountered in 47% of patients. All patients had a fair performance with ECOG /<2. In general, toxicity was mild, none of the patients developed G IV toxicities. All patients completed their planned radiotherapy dose. Gaping during external radiotherapy occurred in only one patient [5.9%] for one week due to GIII diarrhea. On the other hand, chemotherapy was interrupted after the 3rd cycle for only one injection [D22] in two patients; one patient due to GIII diarrhea and the other due to GIII neutropenia. The overall response to the regimen was 94.1% with 64.7% complete response [CR]. The median progression free survival [PFS] was 12 months; however the median overall survival [OAS] was not reached. The 18 month overall survival was 76.3%, while the 18 month progression free survival was 71%