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Clinical outcome observation of preoperative concurrent chemoradiotherapy/radiotherapy alone in 174 Chinese patients with local advanced cervical carcinoma.

Wei LC, Wang N, Shi M, Liu JY, Li JP, Zhang Y, Huang YH, Li X, Chen Y - Onco Targets Ther (2013)

Bottom Line: With median follow-up of 24 months, patients with CR had improved 3-year OS (100% vs 83.6%, P = 0.018) and 3-year PFS (93.1% vs 83.2%, P = 0.035) compared to patients with residual disease.CCRT was associated with significantly improved 3-year PFS (92.0% vs 76.5%, P = 0.032) compared to RT alone in patients with tumor diameter less than 5 cm.Preoperative CCRT achieved outcomes superior to RT alone, depending on the pathologic response, tumor size and lymph-node involvement as major prognostic factors.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology.

ABSTRACT

Objective: To study outcomes of concurrent chemoradiotherapy (CCRT) or radiotherapy (RT) alone followed by radical surgery in patients with local advanced cervical cancer.

Methods: A retrospective approach was carried out in 174 Chinese patients with International Federation of Obstetricians and Gynaecologists stage IB2-IIIB cervical carcinoma. A total of 121 patients were treated with CCRT, while the remaining 53 patients received RT alone, and the regimen of chemotherapy was weekly cisplatin (40 mg/m2). Pathological response, overall survival (OS), progression-free survival (PFS), and complications were analyzed.

Results: The median age was 45 years and the mean primary tumor diameter was 4.8 ± 1.0 cm. Pathological complete response (CR) was achieved in 53 patients (30.5%). The CR rate was relatively higher in the CCRT group (31.4% vs 28.3%, P = 0.724), particularly when tumor diameter was less than 5 cm (38.2% vs 30.8%, P = 0.623). With median follow-up of 24 months, patients with CR had improved 3-year OS (100% vs 83.6%, P = 0.018) and 3-year PFS (93.1% vs 83.2%, P = 0.035) compared to patients with residual disease. CCRT was associated with significantly improved 3-year PFS (92.0% vs 76.5%, P = 0.032) compared to RT alone in patients with tumor diameter less than 5 cm. Thirty-seven patients (21.3%) experienced more than grade 2 toxicity, and one patient (0.6%) developed grade 3 uronephrosis. Data thus indicated that pathologic response, tumor size, and lymph-node involvement were highly correlated with clinical outcomes of the local advanced cervical disease.

Conclusion: Preoperative CCRT achieved outcomes superior to RT alone, depending on the pathologic response, tumor size and lymph-node involvement as major prognostic factors.

No MeSH data available.


Related in: MedlinePlus

Kaplan–Meier survival curves of 174 patients treated with concurrent chemoradiotherapy or radiotherapy alone followed by a radical hysterectomy.Note: The 3-year follow-up indicates that PFS is 90.6% and OS is 93.1%.Abbreviations: OS, overall survival; PFS, progression-free survival.
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f1-ott-6-067: Kaplan–Meier survival curves of 174 patients treated with concurrent chemoradiotherapy or radiotherapy alone followed by a radical hysterectomy.Note: The 3-year follow-up indicates that PFS is 90.6% and OS is 93.1%.Abbreviations: OS, overall survival; PFS, progression-free survival.

Mentions: Median follow-up from the date of surgery was 24 months (range 4–68 months). The 3-year PFS and OS were 90.6% and 93.1%, respectively (Figure 1). The 3-year local pelvic control was 97.1% (n = 169). Death was reported in eleven patients (11/174, 6.3%), from distant metastasis (7/174, 4.0%), pelvic recurrence (2/174, 1.1%), severe complication of renal failure (1/174, 0.6%), and second primary cancer (1/174, 0.6%). There was no statistical significance between CCRT and RT alone in metastasis rate (3/121, 2.5% vs 4/53, 7.5%; P = 0.202) and local recurrence rate (2/121, 1.7% vs 0/53, 0%; P = 1.000), but the tendency showed CCRT could possibly decrease the metastasis rate. In order to exclude the confounding factor, subgroup analysis classified by tumor size and postoperative pathologic response were performed.


Clinical outcome observation of preoperative concurrent chemoradiotherapy/radiotherapy alone in 174 Chinese patients with local advanced cervical carcinoma.

Wei LC, Wang N, Shi M, Liu JY, Li JP, Zhang Y, Huang YH, Li X, Chen Y - Onco Targets Ther (2013)

Kaplan–Meier survival curves of 174 patients treated with concurrent chemoradiotherapy or radiotherapy alone followed by a radical hysterectomy.Note: The 3-year follow-up indicates that PFS is 90.6% and OS is 93.1%.Abbreviations: OS, overall survival; PFS, progression-free survival.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3569376&req=5

f1-ott-6-067: Kaplan–Meier survival curves of 174 patients treated with concurrent chemoradiotherapy or radiotherapy alone followed by a radical hysterectomy.Note: The 3-year follow-up indicates that PFS is 90.6% and OS is 93.1%.Abbreviations: OS, overall survival; PFS, progression-free survival.
Mentions: Median follow-up from the date of surgery was 24 months (range 4–68 months). The 3-year PFS and OS were 90.6% and 93.1%, respectively (Figure 1). The 3-year local pelvic control was 97.1% (n = 169). Death was reported in eleven patients (11/174, 6.3%), from distant metastasis (7/174, 4.0%), pelvic recurrence (2/174, 1.1%), severe complication of renal failure (1/174, 0.6%), and second primary cancer (1/174, 0.6%). There was no statistical significance between CCRT and RT alone in metastasis rate (3/121, 2.5% vs 4/53, 7.5%; P = 0.202) and local recurrence rate (2/121, 1.7% vs 0/53, 0%; P = 1.000), but the tendency showed CCRT could possibly decrease the metastasis rate. In order to exclude the confounding factor, subgroup analysis classified by tumor size and postoperative pathologic response were performed.

Bottom Line: With median follow-up of 24 months, patients with CR had improved 3-year OS (100% vs 83.6%, P = 0.018) and 3-year PFS (93.1% vs 83.2%, P = 0.035) compared to patients with residual disease.CCRT was associated with significantly improved 3-year PFS (92.0% vs 76.5%, P = 0.032) compared to RT alone in patients with tumor diameter less than 5 cm.Preoperative CCRT achieved outcomes superior to RT alone, depending on the pathologic response, tumor size and lymph-node involvement as major prognostic factors.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology.

ABSTRACT

Objective: To study outcomes of concurrent chemoradiotherapy (CCRT) or radiotherapy (RT) alone followed by radical surgery in patients with local advanced cervical cancer.

Methods: A retrospective approach was carried out in 174 Chinese patients with International Federation of Obstetricians and Gynaecologists stage IB2-IIIB cervical carcinoma. A total of 121 patients were treated with CCRT, while the remaining 53 patients received RT alone, and the regimen of chemotherapy was weekly cisplatin (40 mg/m2). Pathological response, overall survival (OS), progression-free survival (PFS), and complications were analyzed.

Results: The median age was 45 years and the mean primary tumor diameter was 4.8 ± 1.0 cm. Pathological complete response (CR) was achieved in 53 patients (30.5%). The CR rate was relatively higher in the CCRT group (31.4% vs 28.3%, P = 0.724), particularly when tumor diameter was less than 5 cm (38.2% vs 30.8%, P = 0.623). With median follow-up of 24 months, patients with CR had improved 3-year OS (100% vs 83.6%, P = 0.018) and 3-year PFS (93.1% vs 83.2%, P = 0.035) compared to patients with residual disease. CCRT was associated with significantly improved 3-year PFS (92.0% vs 76.5%, P = 0.032) compared to RT alone in patients with tumor diameter less than 5 cm. Thirty-seven patients (21.3%) experienced more than grade 2 toxicity, and one patient (0.6%) developed grade 3 uronephrosis. Data thus indicated that pathologic response, tumor size, and lymph-node involvement were highly correlated with clinical outcomes of the local advanced cervical disease.

Conclusion: Preoperative CCRT achieved outcomes superior to RT alone, depending on the pathologic response, tumor size and lymph-node involvement as major prognostic factors.

No MeSH data available.


Related in: MedlinePlus