Cervical Cancer Clinical Trial
Official title:
A Two Part Phase I/II Study Of Extended Field External Irradiation And Intracavitary Brachytherapy Combined With Chemotherapy And Amifostine In Carcinoma Of The Cervix With Positive Para-Aortic Or High Common Iliac Lymph Nodes
RATIONALE: Drugs used in chemotherapy, such as cisplatin, use different ways to stop tumor
cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays
to damage tumor cells. Combining radiation therapy with chemotherapy may kill more tumor
cells. Drugs such as amifostine may protect normal cells from the side effects of radiation
therapy.
PURPOSE: Phase I/II trial to study the effectiveness of combining cisplatin and radiation
therapy with or without amifostine in treating patients who have stage IIIB or stage IVA
cancer of the cervix.
OBJECTIVES:
- Determine the feasibility and tolerability of external beam radiotherapy,
brachytherapy, and cisplatin in patients with para-aortic or high common iliac lymph
node-positive carcinoma of the uterine cervix.
- Determine the feasibility and tolerability of this regimen with the addition of
amifostine in these patients.
- Determine the efficacy of these 2 regimens, in terms of improving pelvic and
para-aortic tumor control and distant metastases, in these patients.
OUTLINE:
- Phase I: Patients undergo external beam radiotherapy to the pelvis and para-aortic
region 5 days a week for 5 weeks. Patients also undergo either intracavitary low-dose
rate (LDR) brachytherapy in 2 applications beginning within 2 weeks after completion of
external beam radiotherapy at 2-3 week intervals or 6 fractions of high-dose rate
intracavitary brachytherapy over 8 weeks beginning as early as week 2 of external beam
radiotherapy. Patients also receive cisplatin IV over 1 hour weekly for 6 weeks
concurrently with external beam radiotherapy and once with LDR brachytherapy. Phase II
proceeds only if toxicity in phase I is within expected parameters.
- Phase II: Patients receive external beam radiotherapy, brachytherapy, and cisplatin as
in phase I. Patients also receive amifostine subcutaneously daily just before external
beam radiotherapy and cisplatin. Treatment continues for up to 8 weeks in the absence
of disease progression or unacceptable toxicity.
Patients are followed every 3 months for 2 years, every 4 months for 1 year, every 6 months
for 2 years, and then annually thereafter.
;
Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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