Localised Cervical Cancer: Impact of Weekly Chemotherapy and Postoperative Radiotherapy in Chinese Women

Introduction: recurrence after treatment for uterine cervical cancer is not uncommon, and its management is a major challenge for the clinician. The aim of this study was to determine the maximum tolerated dose and dose-limiting toxicity of weekly chemotherapy combined with postoperative radiotherapy for uterine cervical cancer. Material and methods: Chinese women with localised uterine cervical cancer were recruited between 2017 and 2020. Pelvic radiotherapy (6 -10 MV X-rays, IMRT 40-45 Gy / 20 fractions, boost of 10-20 Gy/ 5-10fractions on parameters) was followed by brachytherapy (¹⁹²Ir, 10 - 20Gy/2-4fractions). Weekly chemotherapy was initiated with 20 mg/m² cisplatin and 10mg/m² paclitaxel. The 5 + 5 approach to escalate the dose for each 5 patients until the dose-limiting toxicity level was reached was used. Results: a total of 30 patients aged 32-78 years were included. Two out of 5 patients in the dose level 5 group developed grade 3 diarrhoea after 4 weeks. One patient in dose level 4 and 6 developed grade 4 leukopenia and neutropenia, respectively. There were no cases of delayed chemotherapy. With a median follow-up of 64.5 months, 3 patients died after recurrence of metastases. Conclusion: cisplatin - paclitaxel combined with postoperative radiotherapy has been shown to be highly effective and safe in Chinese women with localised uterine cervical cancer. The dose-limiting toxicities are 35 mg/m² cisplatin and 30 mg/m² paclitaxel per week for at least 6 cycles.