Limits...
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

Survival curves of progression-free survival (PFS) (A) and overall survival (OS) (B) of local advanced cervical carcinoma patients with pathological complete response, partial response, and residual carcinoma after preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT)-alone modalities.Notes: The 3-year fellow-up indicates high PFS (94.9%) and OS (100%) in the complete response (CR) group, and low PFS (84.0%) and OS (87.3%) in the residual carcinoma (RC) group. Statistical analysis shows significant differences of PFS and OS between the CR and RC groups (P = 0.035, CR vs RC for 3-year PFS; P = 0.018, CR vs RC for 3-year OS).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3569376&req=5

f3-ott-6-067: Survival curves of progression-free survival (PFS) (A) and overall survival (OS) (B) of local advanced cervical carcinoma patients with pathological complete response, partial response, and residual carcinoma after preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT)-alone modalities.Notes: The 3-year fellow-up indicates high PFS (94.9%) and OS (100%) in the complete response (CR) group, and low PFS (84.0%) and OS (87.3%) in the residual carcinoma (RC) group. Statistical analysis shows significant differences of PFS and OS between the CR and RC groups (P = 0.035, CR vs RC for 3-year PFS; P = 0.018, CR vs RC for 3-year OS).

Mentions: The postoperative pathologic response included CR, PR, and RC. CR was defined as a complete disappearance of all macroscopic and microscopic diseases and mainly showing inflammatory cell infiltration, PR defined as presence of persistent atypical cells or cervical intraepithelial neoplasia, and RC defined as macroscopic and/or microscopic residual disease (Figure 2). The CR rate was 30.5% (53/174), PR rate was 31.6% (55/174), and RC rate was 37.9% (66/174). Among patients with RC, 18 had greater than one-third cervical stromal invasion, four developed capillary-like space involvement, and one had ovarian invasion. Survival status was benefited in the CCRT group in comparison with that of the RC-alone group (P = 0.035, 94.9% vs 84.0% for 3-year PFS; P = 0.018, 100% vs 87.3% for 3-year OS) (Figure 3). The data of this study did not show obvious differences in CR rate between CCRT and RT alone in all 174 cases (38/121, 31.4% vs 15/53, 28.3%; P = 0.724); however, CCRT showed potential benefit for CR rate enhancement (CCRT, 21/55, 38.2% vs RT alone, 8/26, 30.8%; P = 0.623) when tumor size was less than 5 cm.


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)

Survival curves of progression-free survival (PFS) (A) and overall survival (OS) (B) of local advanced cervical carcinoma patients with pathological complete response, partial response, and residual carcinoma after preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT)-alone modalities.Notes: The 3-year fellow-up indicates high PFS (94.9%) and OS (100%) in the complete response (CR) group, and low PFS (84.0%) and OS (87.3%) in the residual carcinoma (RC) group. Statistical analysis shows significant differences of PFS and OS between the CR and RC groups (P = 0.035, CR vs RC for 3-year PFS; P = 0.018, CR vs RC for 3-year OS).
© Copyright Policy
Related In: Results  -  Collection

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

f3-ott-6-067: Survival curves of progression-free survival (PFS) (A) and overall survival (OS) (B) of local advanced cervical carcinoma patients with pathological complete response, partial response, and residual carcinoma after preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT)-alone modalities.Notes: The 3-year fellow-up indicates high PFS (94.9%) and OS (100%) in the complete response (CR) group, and low PFS (84.0%) and OS (87.3%) in the residual carcinoma (RC) group. Statistical analysis shows significant differences of PFS and OS between the CR and RC groups (P = 0.035, CR vs RC for 3-year PFS; P = 0.018, CR vs RC for 3-year OS).
Mentions: The postoperative pathologic response included CR, PR, and RC. CR was defined as a complete disappearance of all macroscopic and microscopic diseases and mainly showing inflammatory cell infiltration, PR defined as presence of persistent atypical cells or cervical intraepithelial neoplasia, and RC defined as macroscopic and/or microscopic residual disease (Figure 2). The CR rate was 30.5% (53/174), PR rate was 31.6% (55/174), and RC rate was 37.9% (66/174). Among patients with RC, 18 had greater than one-third cervical stromal invasion, four developed capillary-like space involvement, and one had ovarian invasion. Survival status was benefited in the CCRT group in comparison with that of the RC-alone group (P = 0.035, 94.9% vs 84.0% for 3-year PFS; P = 0.018, 100% vs 87.3% for 3-year OS) (Figure 3). The data of this study did not show obvious differences in CR rate between CCRT and RT alone in all 174 cases (38/121, 31.4% vs 15/53, 28.3%; P = 0.724); however, CCRT showed potential benefit for CR rate enhancement (CCRT, 21/55, 38.2% vs RT alone, 8/26, 30.8%; P = 0.623) when tumor size was less than 5 cm.

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