Research Article Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome Juan Diaz, 1 Daohai Yu, 2 Bizhan Micaily, 3 J. Stuart Ferriss, 1 and Enrique Hernandez 1 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Hospital, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA 19140, USA 2 Department of Clinical Sciences, Temple Clinical Research Center, Temple University Hospital, Temple University School of Medicine, Philadelphia, PA 19140, USA 3 Department of Radiation Oncology, Temple University Hospital, Temple University School of Medicine, Philadelphia, PA 19140, USA Correspondence should be addressed to Enrique Hernandez; ehernand@temple.edu Received 7 July 2014; Revised 29 September 2014; Accepted 13 October 2014; Published 5 November 2014 Academic Editor: homas Herzog Copyright © 2014 Juan Diaz et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To assess the efectiveness and toxicity of carboplatin concurrent with pelvic external beam radiation and low-dose rate brachytherapy and to assess the impact that adherence to the treatment plan has on outcomes. Methods. Retrospective chart review of 56 patients treated from January 2001 to December 2010. Results. Median follow-up was 68 months. Optimal dose of radiation (ORT) was deined as a minimal cervical dose exceeding 70Gy, point A dose of 80–90Gy, and duration not exceeding 56 days. Only 50% received ORT. In multivariable analyses we only found ORT to be statistically signiicant predictor for progression-free survival (PFS) and overall survival (OS) (HR [95% CI] for non-ORT vs. ORT: 2.4 [1.2, 5.1],  = 0.014 for PFS and 2.2 [1.1, 4.6],  = 0.035 for OS). he 5-year PFS in patients who received ORT was better than that in patients who received non-ORT, 56% vs. 22% (95% CI: [36%, 72%] vs. [9%, 39%]). Patients who received ORT had a better 5-year OS as well (59% vs. 33%; 95% CI: [38%, 75%] vs. [16%, 51%]). Conclusion. Patients with locally advanced cervical cancer treated with weakly carboplatin or cisplatin, teletherapy, and low dose-dose rate brachytherapy have poorer outcomes when treatment duration is prolonged. 1. Introduction A clinical alert was released in 1999 by the National Cancer Institute (NCI) based on the results of ive randomized clin- ical trials of concurrent cisplatin-based chemotherapy and pelvic radiation, suggesting that this approach be considered for all patients with locally advanced cervical carcinoma [1– 5]. Cisplatin’s mechanism of action is mediated by the for- mation of platinum DNA adducts. Since 1999, carboplatin, an analogue of cisplatin, with a similar mechanism of action, has been used with radiation therapy in our institution for the treatment of locally advanced cervical carcinoma. Mechanisms that underlie the interaction between the drugs and radiation therapy may include inhibition of the tumor’s sublethal damage repair systems and an increase in the radiosensitivity of hypoxic cells. Compliance with treatment is very important for local control and overall survival (OS) of patients with locally advanced cervical carcinoma. Carboplatin has decreased nephrotoxicity and neurotoxi- city when compared to cisplatin and is much less emetogenic [6–12]. his favorable toxicity proile when compared to cis- platin may result in better patient adherence to the treatment plan. We sought to assess the outcome of patients with locally advanced cervical cancer treated with carboplatin concurrent with pelvic irradiation and the impact of adherence to the treatment plan. Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2014, Article ID 214351, 6 pages http://dx.doi.org/10.1155/2014/214351