A prospective Phase I study to determ ine toxicity of con-current weekly intravenous cisplatin /whole abdominopelvic radiation therapy followed by four c ycles of intravenous doxorubicin /cisplatin chemothera py.Ten p...A prospective Phase I study to determ ine toxicity of con-current weekly intravenous cisplatin /whole abdominopelvic radiation therapy followed by four c ycles of intravenous doxorubicin /cisplatin chemothera py.Ten patients with advanced endometrial cancer confin ed to the abdominal cavity and /or paraaortic lymph nodes with small residual disease were treated postoperatively with 3000cGy whole abdominopelvic irradiation combin ed with 1500cGy boost to the pelvis or pelvic and aortic fie lds.Cisplatin 15mg /m 2 was given every week during irradiation.After completing radiotherapy,patients were to rece ive doxorubicin 50mg /m 2 and cisplatin 50mg /m 2 every 3weeks for four cycles.Graduated dose reduction and accele ration of the doxoru-bicin dose were specified depending upon hematologic toxicity.Toxicities were monitore d with weekly laboratory studies during treatment and frequent examinations.Five patients with Stage IIIC(paraaortic node involvement )-and five with Stage IVB disease were t reated on this study.Acute toxicity during chemoirradia tion included one patient with grade 4neutropenia and one patient with persistent grade 1thrombocytopenia.Seven patients received chemotherapy after completing radi ation therapy,two pro-gressed before chemotherapy,and on e had thrombocy-topenia.Toxicity during chemotherapy included grade 4neutropenia in all patients with fou r having five episodes of febrile neutropenia.Despite doxorubicin dose reductions for hematologic toxicity,three patients exhibited grade 4neutropenia after both the second an d third cycles.One patient developed a small bowel obstruction from radiation therapy that required surgery.There were no treatment -re-lated deaths.Overall median surviv al was 14months,with only one long -term survivor free of disease at 58months.Without cytokine support,whole abdominopelvic irradiation and concurrent weekly cisplatin followed by doxorubicin /cisplatin chemotherapy without cytokine support has pro-hibitive hematologic toxicity.展开更多
文摘A prospective Phase I study to determ ine toxicity of con-current weekly intravenous cisplatin /whole abdominopelvic radiation therapy followed by four c ycles of intravenous doxorubicin /cisplatin chemothera py.Ten patients with advanced endometrial cancer confin ed to the abdominal cavity and /or paraaortic lymph nodes with small residual disease were treated postoperatively with 3000cGy whole abdominopelvic irradiation combin ed with 1500cGy boost to the pelvis or pelvic and aortic fie lds.Cisplatin 15mg /m 2 was given every week during irradiation.After completing radiotherapy,patients were to rece ive doxorubicin 50mg /m 2 and cisplatin 50mg /m 2 every 3weeks for four cycles.Graduated dose reduction and accele ration of the doxoru-bicin dose were specified depending upon hematologic toxicity.Toxicities were monitore d with weekly laboratory studies during treatment and frequent examinations.Five patients with Stage IIIC(paraaortic node involvement )-and five with Stage IVB disease were t reated on this study.Acute toxicity during chemoirradia tion included one patient with grade 4neutropenia and one patient with persistent grade 1thrombocytopenia.Seven patients received chemotherapy after completing radi ation therapy,two pro-gressed before chemotherapy,and on e had thrombocy-topenia.Toxicity during chemotherapy included grade 4neutropenia in all patients with fou r having five episodes of febrile neutropenia.Despite doxorubicin dose reductions for hematologic toxicity,three patients exhibited grade 4neutropenia after both the second an d third cycles.One patient developed a small bowel obstruction from radiation therapy that required surgery.There were no treatment -re-lated deaths.Overall median surviv al was 14months,with only one long -term survivor free of disease at 58months.Without cytokine support,whole abdominopelvic irradiation and concurrent weekly cisplatin followed by doxorubicin /cisplatin chemotherapy without cytokine support has pro-hibitive hematologic toxicity.
