Clinical Outcome for Chemoradiotherapy in Carcinoma of the Cervix

Spensley, Saiqa; Hunter, Robin D; Livsey, Jacqueline E; Swindell, Ric; Davidson, Susan E

doi:10.1016/j.clon.2008.10.014

Cited by 36 publications

(31 citation statements)

References 27 publications

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“…Outcome of patients with locally advanced disease has improved in recent years with the adoption of concurrent chemoradiotherapy (Green et al, 2001). However, the overall 5-year survival rate is still only around 60% and the use of concurrent chemotherapy may increase the risk of late toxicity (Spensley et al, 2009). Consequently, there is a need to predict, before treatment, those patients likely to respond to radiotherapy alone and those who might benefit from combination therapy and/or the addition of novel targeted therapeutic agents.…”

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confidence: 99%

Enhancing fraction measured using dynamic contrast-enhanced MRI predicts disease-free survival in patients with carcinoma of the cervix

et al. 2009

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Background: There is a need for simple imaging parameters capable of predicting therapeutic outcome. Methods: This retrospective study analysed 50 patients with locally advanced carcinoma of the cervix who underwent dynamic contrast-enhanced MRI before receiving potentially curative radiotherapy. The proportion of enhancing pixels ( E F ) in the whole-tumour volume post-contrast agent injection was calculated and assessed in relation to disease-free survival (DFS). Results: Tumours with high E F had a significantly poorer probability of DFS than those with low E F ( P =0.011). Interpretation: E F is a simple imaging biomarker that should be studied further in a multi-centre setting.

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Enhancing fraction measured using dynamic contrast-enhanced MRI predicts disease-free survival in patients with carcinoma of the cervix

et al. 2009

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“…According to Spensly et al the 3-year overall survival rate was 70%, with an estimated 5-year overall survival rate of 60%. The 3-year disease-free survival was 63.6%, with an estimated 5-year disease-free survival rate of 55% 22 .…”

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confidence: 99%

A Comparative Study of Result of Treatment of Cancer Cervix Patients Treated by Two Separate Schedules of Radiotherapy

Akhtar

Hossain

Masud

et al. 2013

Bangladesh J Obstet Gynaecol

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Background: Cervical cancer is the most common cancer of Bangladeshi women diagnosed mostly (>80%) at stage II and stage III. Rdaiotherapy (both teletherapy and brachytherapy) is the most important modality of treatment at these stages.Objective: To compare the local control, diseases free survival and overall survival between the (cancer cervix) patients treated randomly by two schedules of radiotherapy. Method: From June 1996 to June 2005, patients with histologically confirmed carcinoma cervix (Ca.cervix) were treated by external beam therapy (EBRT) as well as intra cavitery brachytherapy (ICRT) along with concurrent/sequential chemotherapy with cisplatin and 5- Fluorouracil. EBRT was given by cobalt60 teletherapy machine and ICRT by caesium137 low dose rate machine. The patients were divided into two groups according to treatment schedules. Group I: the patients in this group received EBRT in whole pelvis in two steps, first with open field upto 10-20 Gy then by applying midline shield with lead block 30-40Gy in 25-28 total fractions, five days a week; they also received 50-70 Gy to point A by ICRT in 2-4 weekly fractions. Group II: patients in this group received with open field a dose of 45-50Gy in 25-28 fractions, 5 days a week by EBRT and 25-30 Gy at point A by ICRT in 1-2 weekly fractions.Result: In Group I, 96 out of 101 and in Group II, 104 out of 118 patients were eligible for evaluation. In both groups patients were distributed according to stages and age more or less equally; their age range were 30-70 years and mean age was 47.2 years in Group I and age range were 25-80 years and mean age was 46 years in Group II. Squamous cell carcinoma were found (90%) and performance status was WHO grade 0-1 (>75%) in both groups. Local control of disease at 5 years was 65% in group I and 51% in group II. Overall survival at 2 years, 5 years, 7 years and 9 years in group I, was 71%, 64%, 55%, 46% and in group II, 54%,50%, 43%,32% respectively. Distant metastasis occurred in 22% in-group I and 28% in-group II. Lymph node, lung, liver, peritoneum were common site of metastasis. Proctitis, cystitis, vaginal stenosis in group I was 80%, 33% 16% and in Group II 29%, 13% and 5% respectively. Conclusion: External beam therapy and brachytherapy was effective treatment in carcinoma. Cervix in both operable and inoperable stages. In small volume of tumor, both schedules of radiotherapy were more or less equivalent but in bulky diseases Group I schedule that was higher dose by brachytherapy at point A showed better result; though the complication was more DOI: http://dx.doi.org/10.3329/bjog.v25i2.13739 Bangladesh J Obstet Gynaecol, 2010; Vol. 25(2) : 50-58

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“…External beam radiation is used to treat the pelvic nodes and parametria, whereas the central disease is primarily treated by the intracavitory brachytherapy. Adjuvant hysterectomy after radical chemoradiotherapy has not been shown to be associated with survival benefit [2,3]. However, in patients in whom brachytherapy is not feasible due to various reasons, the total radiation dose is compromised.…”

Section: Discussionmentioning

confidence: 99%

The Role of Adjuvant Hysterectomy After Radiotherapy in Cervical Cancer

et al. 2014

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The aim of this study was to evaluate the morbidity and survival outcome following radical hysterectomy after chemoradiotherapy in the International Federation of Gynecology and Obstetrics (FIGO) stages IB-IIB cervical cancer patients in whom intracavitory brachytherapy was not feasible. We retrospectively reviewed the medical records of our patients who underwent adjuvant radical hysterectomy between January 2005 and December 2012. Post-operative complications were graded according to the grading system of Chassagne et al. (Radiother Oncol 26:195-202, 1993). Survival analysis was done using Kaplan-Meir method. Between January 2005 and December 2012, 43 patients underwent type 2 radical hysterectomy after external beam radiotherapy and concurrent chemotherapy. The median age of the study group was 44 years (range 28-63 years). There were no perioperative deaths. In the early post-operative period, there were 45 complications in 29 patients of which three were of grade 3 severity. The most common post operative complications were urinary tract infections and lymphoedema. The median follow-up time was 29 months (range 9-68 months). The 5-year overall survival was 85.5 % and disease-free survival 82.1 %. This study shows that radical hysterectomy is feasible with good survival outcome and acceptable morbidity after chemoradiotherapy in cervical cancer patients.

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Clinical Outcome for Chemoradiotherapy in Carcinoma of the Cervix

Cited by 36 publications

References 27 publications

Enhancing fraction measured using dynamic contrast-enhanced MRI predicts disease-free survival in patients with carcinoma of the cervix

Enhancing fraction measured using dynamic contrast-enhanced MRI predicts disease-free survival in patients with carcinoma of the cervix

A Comparative Study of Result of Treatment of Cancer Cervix Patients Treated by Two Separate Schedules of Radiotherapy

The Role of Adjuvant Hysterectomy After Radiotherapy in Cervical Cancer

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