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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

(A–C) Three major pathological responses, ie, complete response (CR), partial response (PR), and residual carcinoma (RC) in patients treated with preoperative concurrent chemoradiotherapy or radiotherapy alone. CR (A) shows mainly inflammatory cell infiltration, PR (B) shows presence of persistent atypical cells or cervical intraepithelial neoplasia, and RC (C) shows residual tumor tissue or tumor cells in cervical tissue.
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f2-ott-6-067: (A–C) Three major pathological responses, ie, complete response (CR), partial response (PR), and residual carcinoma (RC) in patients treated with preoperative concurrent chemoradiotherapy or radiotherapy alone. CR (A) shows mainly inflammatory cell infiltration, PR (B) shows presence of persistent atypical cells or cervical intraepithelial neoplasia, and RC (C) shows residual tumor tissue or tumor cells in cervical tissue.

Mentions: On multivariate analysis, the following prognostic factors were highly correlated with survival: primary tumor diameter, age, postoperative pathologic response, and pelvic lymph-node involvement status (Table 2 and Figure 2). Positive lymph-node involvements were confirmed in 15 patients (twelve patients in the CCRT and three patients in the RT alone group). There was no statistically significant difference in lymph-node involvement status between CCRT and RT alone (12/121, 9.9% vs 3/53, 5.7%; P = 0.058).


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)

(A–C) Three major pathological responses, ie, complete response (CR), partial response (PR), and residual carcinoma (RC) in patients treated with preoperative concurrent chemoradiotherapy or radiotherapy alone. CR (A) shows mainly inflammatory cell infiltration, PR (B) shows presence of persistent atypical cells or cervical intraepithelial neoplasia, and RC (C) shows residual tumor tissue or tumor cells in cervical tissue.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569376&req=5

f2-ott-6-067: (A–C) Three major pathological responses, ie, complete response (CR), partial response (PR), and residual carcinoma (RC) in patients treated with preoperative concurrent chemoradiotherapy or radiotherapy alone. CR (A) shows mainly inflammatory cell infiltration, PR (B) shows presence of persistent atypical cells or cervical intraepithelial neoplasia, and RC (C) shows residual tumor tissue or tumor cells in cervical tissue.
Mentions: On multivariate analysis, the following prognostic factors were highly correlated with survival: primary tumor diameter, age, postoperative pathologic response, and pelvic lymph-node involvement status (Table 2 and Figure 2). Positive lymph-node involvements were confirmed in 15 patients (twelve patients in the CCRT and three patients in the RT alone group). There was no statistically significant difference in lymph-node involvement status between CCRT and RT alone (12/121, 9.9% vs 3/53, 5.7%; P = 0.058).

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