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 3-year progression-free survival (PFS) (A) and overall survival (OS) (B) in 81 local advanced cervical carcinoma patients with tumor size less than 5 cm and treated with preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT) alone.Notes: CCRT showed improved 3-year PFS but not OS compared with RT alone. Statistical analysis shows significant differences between CCRT and RT alone (P = 0.032, 92.0% CCRT vs 76.5% RT alone for 3-year PFS; P = 0.055, CCRT vs RT alone for OS).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3569376&req=5

f4-ott-6-067: Survival curves of 3-year progression-free survival (PFS) (A) and overall survival (OS) (B) in 81 local advanced cervical carcinoma patients with tumor size less than 5 cm and treated with preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT) alone.Notes: CCRT showed improved 3-year PFS but not OS compared with RT alone. Statistical analysis shows significant differences between CCRT and RT alone (P = 0.032, 92.0% CCRT vs 76.5% RT alone for 3-year PFS; P = 0.055, CCRT vs RT alone for OS).

Mentions: According to Cox regression analysis, there was no statistical difference in survival between preoperative CCRT and RT alone (3-year PFS, 92.0% vs 86.7%, P = 0.069; 3-year OS, 95.0% vs 88.1%, P = 0.124) for all 174 patients. Nevertheless, preoperative CCRT did have significantly improved 3-year PFS (P = 0.032, 92.0% CCRT vs 76.5% RT alone), but not OS (P = 0.055, 94.4% CCRT vs 53.6% RT alone) compared with RT alone when tumor size was less than 5 cm. Statistical data analysis for those 81 patients with tumor size less than 5 cm treated with CCRT or RT alone is shown in Figure 4.


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 3-year progression-free survival (PFS) (A) and overall survival (OS) (B) in 81 local advanced cervical carcinoma patients with tumor size less than 5 cm and treated with preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT) alone.Notes: CCRT showed improved 3-year PFS but not OS compared with RT alone. Statistical analysis shows significant differences between CCRT and RT alone (P = 0.032, 92.0% CCRT vs 76.5% RT alone for 3-year PFS; P = 0.055, CCRT vs RT alone for OS).
© Copyright Policy
Related In: Results  -  Collection

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

f4-ott-6-067: Survival curves of 3-year progression-free survival (PFS) (A) and overall survival (OS) (B) in 81 local advanced cervical carcinoma patients with tumor size less than 5 cm and treated with preoperative concurrent-chemoradiotherapy (CCRT) or radiotherapy (RT) alone.Notes: CCRT showed improved 3-year PFS but not OS compared with RT alone. Statistical analysis shows significant differences between CCRT and RT alone (P = 0.032, 92.0% CCRT vs 76.5% RT alone for 3-year PFS; P = 0.055, CCRT vs RT alone for OS).
Mentions: According to Cox regression analysis, there was no statistical difference in survival between preoperative CCRT and RT alone (3-year PFS, 92.0% vs 86.7%, P = 0.069; 3-year OS, 95.0% vs 88.1%, P = 0.124) for all 174 patients. Nevertheless, preoperative CCRT did have significantly improved 3-year PFS (P = 0.032, 92.0% CCRT vs 76.5% RT alone), but not OS (P = 0.055, 94.4% CCRT vs 53.6% RT alone) compared with RT alone when tumor size was less than 5 cm. Statistical data analysis for those 81 patients with tumor size less than 5 cm treated with CCRT or RT alone is shown in Figure 4.

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