Concomitant chemobrachyradiotherapy with ifosfamide and cisplatin followed by consolidation chemotherapy for women with locally advanced carcinoma of the uterine cervix—Final results of a prospective phase II-study

Vrdoljak, Eduard; Omrčen, Tomislav; Novaković, Žana Saratlija; Jelavić, Tihana Boraska; Prskalo, Tomislav; Hrepić, Dario; Hamm, Wolfgang

doi:10.1016/j.ygyno.2006.03.060

Cited by 31 publications

(22 citation statements)

References 32 publications

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“…In a recent review, providing additional paclitaxel to treatment, extending the chemotherapy course, and selecting a biological target such as anti-VEGF or anti-epidermal growth factor receptor agents are suggested to have a potential role in the management of adenocarcinoma of the cervix (Gien et al , 2010). Finally, as the survival outcomes of patients with risk-weighted surgical score ⩾12.5 is similar to advanced-stage disease, the indication and efficacy of consolidation therapy after postoperative adjuvant treatment needs to be considered in the future (Vrdoljak et al , 2006; Zhang et al , 2010; Choi et al , 2011). …”

Section: Discussionmentioning

confidence: 99%

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

et al. 2013

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Background:Surgical–pathological risk factors were evaluated by weighting the magnitude of significance of multiple risk factors correlating to survival and treatment response in cervical cancer.Methods:Multivariate analysis was performed for survival outcomes entering seven pathological factors obtained from 540 radical hysterectomy specimens in stage IA2-IIB cervical cancer cases. Hazard ratio (HR) in each risk factor was determined, and the sum of HR scores for the corresponding risk factors was determined per case. Survival curves and postoperative treatment response (concurrent chemoradiotherapy (CCRT) vs radiotherapy alone) were evaluated based on the extent of HR-weighted scores.Results:Hazard ratios for risk factors relating to disease-free survival (DFS) was: lympho-vascular space invasion 3.95, nodal metastasis 3.88, adenocarcinoma 3.40, large tumour 2.36, positive margin 1.99, deep stromal invasion 1.29, and parametria invasion 1.21. The HR-weighted scoring method showed a high predictive value for recurrence (area-under-curve 0.836, P<0.001). Hazard ratio-weighted scores were negatively correlated to DFS, and the cases with score ⩾12.5 showed 5-year DFS rate of 23.8%. Tumours with larger score offset the benefits of CCRT over radiotherapy alone for postoperative adjuvant treatment (P<0.001).Conclusion:Surgical–pathological risk factors provide valuable information for survival and management of early-stage cervical cancer when number and significance of risks are weighted.

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Section: Discussionmentioning

confidence: 99%

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

et al. 2013

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“…Potentially successful strategy to improve local control is combining chemotherapy and LDR brachyradiotherapy to improve systemic control administering consolidation therapy. 8 When designing new regimens for the successful treatment of LACC, we must take into consideration their price and feasibility.…”

Section: Discussionmentioning

confidence: 99%

“…5,7 Trying to improve the outcome, we designed a regimen of concomitant chemobrachyradiotherapy with cisplatin and ifosfamide followed by 4 cycles of consolidation chemotherapy. 8 The concept of our regimen was based on few main principles. The first was to concomitantly apply radiotherapy with chemotherapy with known radiosensitizing properties and proven efficacy in the treatment of cervical cancer (combination of cisplatin + ifosfamide).…”

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confidence: 99%

“…12,13 Results of the phase II study in which we described the outcomes of 62 patients after a median follow-up of 49 months were previously published. 8,14 Because of the excellent results we achieved (recurrence-free and overall survival [OS] rate of 88.7%), we adopted this study protocol as a standard approach for the treatment of LACC in our institution. Now, we present data on 118 patients treated between 1999 and 2012.…”

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Long Follow-up of Patients With Locally Advanced Cervical Cancer Treated With Concomitant Chemobrachyradiotherapy With Cisplatin and Ifosfamide Followed by Consolidation Chemotherapy

Miše

Jelavić

Strikić

et al. 2015

Int J Gynecol Cancer

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“…Wong et al [19] showed that chemoradiation followed by adjuvant chemotherapy with epirubicin had a less frequent distant failure without difference in local failure rate. Vrdoljak et al [20,21] reported promising results after consolidation chemotherapy with ifosfamide and cisplatin after concomitant chemobrachyradiotherapy. Recently, Choi et al [22] reported that three more cycles of consolidation FP chemotherapy after CCRT might have a role as a radiosensitizer during the period of delayed radiation effect and lead to an encouraging survival rate, with acceptable toxicity.…”

Section: Discussionmentioning

confidence: 99%

Comparison of concurrent chemoradiation therapy with weekly cisplatin versus monthly fluorouracil plus cisplatin in FIGO stage IIB-IVA cervical cancer

et al. 2012

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ObjectiveConcurrent chemoradiation therapy (CCRT) is the standard treatment for locally advanced cervical cancer. Although the optimal chemotherapeutic regimen is not yet defined, previous randomized trials have demonstrated that 5-fluorouracil (5-FU) plus cisplatin every 3 weeks and weekly cisplatin are the most popular regimens. The purpose of this study was to compare the outcomes of weekly CCRT with cisplatin and monthly CCRT with 5-FU plus cisplatin for locally advanced cervical cancer.MethodsWe retrospectively reviewed data from 255 patients with FIGO stage IIB-IVA cervical cancer. Patients were classified into two CCRT groups according to the concurrent chemotherapy: weekly CCRT group, consisted of CCRT with weekly cisplatin for six cycles; and monthly CCRT group, consisted of CCRT with cisplatin and 5-FU every 4 weeks for two cycles followed by additional consolidation chemotherapy for two cycles with the same regimen.ResultsOf 255 patients, 152 (59.6%) patients received weekly CCRT and 103 (40.4%) received monthly CCRT. The mean follow-up period was 39 months (range, 1 to 186 months). Planned CCRT was given to 130 (85.5%) patients in weekly CCRT group and 84 (81.6%) patients in monthly CCRT group, respectively. Severe adverse effects were more common in the monthly CCRT group than in the weekly CCRT group. There were no statistically significant differences in progression-free survival and overall survival between the two groups (p=0.715 and p=0.237).ConclusionBoth weekly CCRT and monthly CCRT seem to have similar efficacy for patients with locally advanced cervical cancer, but the weekly cisplatin is better tolerated.

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Concomitant chemobrachyradiotherapy with ifosfamide and cisplatin followed by consolidation chemotherapy for women with locally advanced carcinoma of the uterine cervix—Final results of a prospective phase II-study

Cited by 31 publications

References 32 publications

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

Utility of risk-weighted surgical–pathological factors in early-stage cervical cancer

Long Follow-up of Patients With Locally Advanced Cervical Cancer Treated With Concomitant Chemobrachyradiotherapy With Cisplatin and Ifosfamide Followed by Consolidation Chemotherapy

Comparison of concurrent chemoradiation therapy with weekly cisplatin versus monthly fluorouracil plus cisplatin in FIGO stage IIB-IVA cervical cancer

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