Análisis retrospectivo institucional de tratamiento quimio-radioterápico definitivo en cáncer de cuello uterino localmente avanzado

Tomás Soulé; Juan Pablo Sade; Gonzalo Giornelli; Mauro Orlando; Sergio Rivero; Matías Chacón; Reinaldo Chacón

doi:10.56969/oc.v21i3.85

Autores/as

Tomás Soulé Instituto Alexander Fleming, Buenos Aires
Juan Pablo Sade Instituto Alexander Fleming, Buenos Aires
Gonzalo Giornelli Instituto Alexander Fleming, Buenos Aires
Mauro Orlando Instituto Alexander Fleming, Buenos Aires
Sergio Rivero Instituto Alexander Fleming, Buenos Aires https://orcid.org/0000-0002-7832-4203
Matías Chacón Instituto Alexander Flemming, Buenos Aires https://orcid.org/0000-0002-4935-9773
Reinaldo Chacón Instituto Alexander Fleming, Buenos Aires

DOI:

https://doi.org/10.56969/oc.v21i3.85

Palabras clave:

cérvix, cisplatino, gemcitabine, radio-quimioterapia, cisplatin, chemo radiotherapy

Resumen

El objetivo fue analizar retrospectivamente, en pacientes con cáncer de cuello uterino localmente avanzado tratados en nuestro centro, el perfil de toxicidad de la radioterapia concurrente con platinos mono droga o combinados con gemcitabine y su impacto en el tratamiento.

Estudio descriptivo, retrospectivo y observacional de pacientes con cáncer de cuello uterino localmente avanzado (estadios IIa/IVa) desde marzo de 2011 a febrero de 2016. Se analizaron características patológicas, dosis de tratamiento radiante y quimioterápico, así como toxicidades graves (GIII/IV) y su impacto en el tratamiento, observado como reducción o suspensión de dosis y/o split de radioterapia (RT).

Se evaluaron 60 pacientes, edad mediana 47 años (17-75), 93% PS0-1. Histología: escamoso (89%) y adenocarcinoma (8%). Estadio IIb 24 (40%) y IIIb 16 (27%). Dosis de RT utilizada 5040cGy; 35 (58%) realizaron boost y 47 (78%) braquiterapia posterior. Cuarenta y cinco realizaron tratamiento concurrente con PLA y 15 con platinos/gemcitabine (PLA/GEM). En el grupo que recibió PLA, uno requirió reducción de dosis de quimioterapia (QT), dos suspendieron algún ciclo por toxicidad y tres realizaron split de RT. El 100% completó el tratamiento de quimio- radioterapia (QRT) concurrente. En el grupo que recibió PLA/GEM: 9 requirieron reducción de dosis de QT, 11 suspendieron algún ciclo y 4 no completaron el esquema por toxicidad; 4 hicieron split de RT, y 87% completó el tratamiento de RT.

En este estudio, el esquema concurrente con quimioterapia combinada muestra mayor toxicidad que impacta en el cumplimiento del tratamiento, 15% no lo completó por toxicidades graves. No obstante, un correcto manejo institucional de toxicidades, permite utilizar la combinación de tratamiento para obtener potenciales beneficios.

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