The influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospital

dc.contributor.advisorvan Wijk, Leonen_ZA
dc.contributor.authorJemu, Mtabenien_ZA
dc.date.accessioned2018-01-30T10:21:14Z
dc.date.available2018-01-30T10:21:14Z
dc.date.issued2017en_ZA
dc.description.abstractObjective: To examine the effect of treatment and tumour factors on the overall survival (OS) of patients completing chemo-radiation (CRT) for stage IIB cervical cancer. Materials and methods: Retrospective audit of 228 patients with stage IIB cervical cancer treated between 1995 and 2010, who received CRT with at least 45 Gy external beam radiation, two to four brachytherapy insertions, and one or more cycles of concurrent weekly cisplatin (40mg/m², capped at 60 mg/week). Results: Mean tumour size was 5.5cm, bilateral parametrial involvement in 40% of patients, lateral parametrial involvement in 50%, and vaginal spread in 43%. Mean total dose to Point A was 83 Gy (range 61-96) linear quadratic equivalent dose to 2 Gy/fraction. Mean overall treatment time (OTT) was 45 days. The average weekly haemoglobin (AWHB) during treatment was 11.6 g/dL (range 8.8-15.5). Blood transfusions before or during chemo-radiation were given in 33% of patients. Two thirds of patients completed five or six cycles of weekly cisplatin. Reasons for fewer than five cycles were: scheduling failure, neutropaenia, and/or renal impairment. No outcome differences were observed for Monday vs. Thursday cisplatin administration. The 5-year OS was 60%. Patients completing fewer than six cycles had a worse OS (55 vs. 76%, p=0.02). By multiple regression analysis for OS, only six cycles of cisplatin, squamous histology, and AWHB>10g/dL were significant. Conclusions: Maintaining HB>10 and administering six cycles of weekly cisplatin at the dose regimen used appear to be requirements for maximal benefit during CRT of stage IIB cervical cancer.en_ZA
dc.identifier.apacitationJemu, M. (2017). <i>The influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospital</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Radiation Oncology. Retrieved from http://hdl.handle.net/11427/27085en_ZA
dc.identifier.chicagocitationJemu, Mtabeni. <i>"The influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospital."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Radiation Oncology, 2017. http://hdl.handle.net/11427/27085en_ZA
dc.identifier.citationJemu, M. 2017. The influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospital. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Jemu, Mtabeni AB - Objective: To examine the effect of treatment and tumour factors on the overall survival (OS) of patients completing chemo-radiation (CRT) for stage IIB cervical cancer. Materials and methods: Retrospective audit of 228 patients with stage IIB cervical cancer treated between 1995 and 2010, who received CRT with at least 45 Gy external beam radiation, two to four brachytherapy insertions, and one or more cycles of concurrent weekly cisplatin (40mg/m², capped at 60 mg/week). Results: Mean tumour size was 5.5cm, bilateral parametrial involvement in 40% of patients, lateral parametrial involvement in 50%, and vaginal spread in 43%. Mean total dose to Point A was 83 Gy (range 61-96) linear quadratic equivalent dose to 2 Gy/fraction. Mean overall treatment time (OTT) was 45 days. The average weekly haemoglobin (AWHB) during treatment was 11.6 g/dL (range 8.8-15.5). Blood transfusions before or during chemo-radiation were given in 33% of patients. Two thirds of patients completed five or six cycles of weekly cisplatin. Reasons for fewer than five cycles were: scheduling failure, neutropaenia, and/or renal impairment. No outcome differences were observed for Monday vs. Thursday cisplatin administration. The 5-year OS was 60%. Patients completing fewer than six cycles had a worse OS (55 vs. 76%, p=0.02). By multiple regression analysis for OS, only six cycles of cisplatin, squamous histology, and AWHB>10g/dL were significant. Conclusions: Maintaining HB>10 and administering six cycles of weekly cisplatin at the dose regimen used appear to be requirements for maximal benefit during CRT of stage IIB cervical cancer. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - The influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospital TI - The influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospital UR - http://hdl.handle.net/11427/27085 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27085
dc.identifier.vancouvercitationJemu M. The influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospital. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Radiation Oncology, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27085en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Radiation Oncologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherRadiation Oncologyen_ZA
dc.titleThe influence of cisplatin dose variations during concurrent weekly chemo-radiation in stage IIB cervical cancer at Groote Schuur Hospitalen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
thesis_hsf_2017_jemu_mtabeni (1).pdf
Size:
1.51 MB
Format:
Adobe Portable Document Format
Description:
Collections