3790 - Impact of Age on Chemotherapy Dose in Patients with Node Negative Cervical Cancer Treated with Chemoradiotherapy: A Prospective Observational Study

Purpose/Objective(s):

Cervical cancer is predominantly managed in resource-constrained low-middle-income country settings using 3D-conformal RT without bone marrow-sparing techniques. This prospective observational study explored age as a predictor of hematologic toxicity and cisplatin dose delivered in node-negative patients undergoing chemoradiotherapy for cervical cancer.

Materials/Methods:

88 patients with stage IB-IVA node negative cervical cancer were recruited. Treatment was with RT using 3Dimensional conformal technique to 46Gy/23# followed by brachytherapy. All patients received concurrent chemo with weekly cisplatin (40mg/m2). Patients were reviewed weekly with hemogram from start of treatment till completion. Descriptive statistics, independent sample t test, Pearson correlation and regression analysis were used for analysis.

Results:

The mean (SD) age was 58.2(8.4) years. 66 patients were <65 years and 22 were = 65 years. Significant difference was observed in the dose of Cisplatin (p=0.001) with mean (SD) dose of CDDP being 250.6(55.8) mg and 195(58) mg in the < and = 65 age group respectively. Hematologic toxicities were higher in the older age group with low counts being the most important reason for deferral of chemo. After adjusting for stage, BM doses, treatment duration and BSA, age remained a significant variable determining the total chemo received (r2=0.29, p=0.039).

Conclusion:

Higher hematologic toxicities during treatment for cervical cancer makes it difficult to deliver recommended doses of chemotherapy in patients = 65 years. BM sparing RT techniques may be recommended for them to reduce hematologic toxicities and increase chemotherapy doses.