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Concurrent chemoradiotherapy followed by adjuvant chemotherapy in uterine cervical cancer patients with high-risk factors

 Yong Bae Kim  ;  Jae Ho Cho  ;  Gwi Eon Kim  ;  Chang Ok Suh  ;  Jinsil Seong  ;  Chang Geol Lee  ;  Ki Chang Keum 
 GYNECOLOGIC ONCOLOGY, Vol.104(1) : 58-63, 2007 
Journal Title
Issue Date
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage* ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Brachytherapy ; Carboplatin/administration & dosage ; Carboplatin/adverse effects ; Carcinoma, Squamous Cell/drug therapy* ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/radiotherapy* ; Chemotherapy, Adjuvant/adverse effects ; Cisplatin/administration & dosage ; Cisplatin/adverse effects ; Dose Fractionation, Radiation ; Female ; Fluorouracil/administration & dosage ; Fluorouracil/adverse effects ; Humans ; Middle Aged ; Neoplasm Staging ; Prognosis ; Radiotherapy/adverse effects ; Retrospective Studies ; Risk Factors ; Uterine Cervical Neoplasms/drug therapy* ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/radiotherapy*
OBJECTIVES: To determine whether concurrent chemoradiotherapy (CCRT) followed by adjuvant chemotherapy is better than CCRT alone in the management of FIGO stage bulky IB and IIB uterine cervical cancer. METHODS: Two hundred and five FIGO stage bulky IB and IIB patients with squamous cell carcinoma of the uterine cervix treated with CCRT were divided into 2 groups: (1) CCRT alone (n=103, Group A) and (2) CCRT plus adjuvant chemotherapy (n=102, Group B), and treatment outcomes were retrospectively compared between the two patient groups. RESULTS: Only 63% of patients received all three planned cycles of adjuvant chemotherapy, while 16% received only one cycle because of increased treatment-related morbidity or other causes. There were no treatment-related deaths. Although 37 patients experienced failures after completion of treatment, no significant differences were found in patterns of local and regional failures between the two groups. The incidence of distant metastasis, including para-aortic or supraclavicular lymph node metastases, was not reduced in patients of Group B (8% in Group A vs. 7% in Group B). Overall five-year actuarial survival rates for Group A and Group B patients were 85% vs. 80%, and five-year disease-free survival rates were 83% vs. 78%, respectively. CONCLUSIONS: Our data failed to show discernable therapeutic advantage of adjuvant chemotherapy with given after CCRT for the management of FIGO stage bulky IB and IIB uterine cervical cancer patients. A future clinical trial will be necessary to test the clinical efficacy of the adjuvant treatment using newly developed agents in uterine cervical cancer patients.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Keum, Ki Chang(금기창) ORCID logo https://orcid.org/0000-0003-4123-7998
Kim, Gwi Eon(김귀언)
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Suh, Chang Ok(서창옥)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
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