Concurrent weekly cisplatin plus external beam radiotherapy and high-dose rate brachytherapy for advanced cervical cancer: A control cohort comparison with radiation alone on treatment outcome and complications

Chen, Shang-Wen; Liang, Ji An; Hung, Yao Ching; Yeh, Lian Shung; Chang, Wei Chun; Lin, Wen‐Chuan; Yang, Shih Neng; Lin, Fan

doi:10.1016/j.ijrobp.2006.07.004

Cited by 52 publications

(48 citation statements)

References 24 publications

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“…Although several reports have indicated that the cumulative dose at the rectal reference point correlated well to the incidence of proctitis, [28][29][30] the clinical application of this concept is limited. 27,31 …”

Section: International Commission On Radiation Units and Measurementsmentioning

confidence: 99%

“…Table 4 shows a comparison of the standard treatment schedules and doses of defi nitive radiotherapy for HDR-ICBT and EBRT between Japan and the United States. 5,9,31 The Japanese standard schedule has lower total radiation doses compared with those in the United States. Several PCSs have revealed this observation in clinical practice.…”

Section: Future Perspectivesmentioning

confidence: 99%

“…Several PCSs have revealed this observation in clinical practice. 10,11,31 The Japanese schedule was determined based on extensive clinical experience from the National Institute of Radiological Sciences in Chiba, Japan. 6 In other words, this standard schedule is empirical and has not yet been determined through prospective trials.…”

Section: Future Perspectivesmentioning

confidence: 99%

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Current status and perspectives of brachytherapy for cervical cancer

Toita

2009

Int J Clin Oncol

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Standard definitive radiotherapy for cervical cancer consists of whole pelvic external beam radiotherapy (EBRT) and intracavitary brachytherapy (ICBT). In Japan, high-dose-rate ICBT (HDR-ICBT) has been utilized in clinical practice for more than 40 years. Several randomized clinical trials demonstrated that HDR-ICBT achieved comparative outcomes, both for pelvic control and incidences of late complications, to low-dose-rate (LDR) ICBT. In addition, HDR-ICBT has some potential advantages over LDR-ICBT, leading to further improvement in treatment results. Prior to the current computer planning systems, some excellent treatment planning concepts were established. At present, systems modified from these concepts, or novel approaches, such as image-guided brachytherapy (IGBT) are under investigation. One serious problem to be solved in HDR-ICBT for cervical cancer is that of the discrepancy in standard treatment schedules for combination HDR-ICBT and EBRT between the United States and Japan. Prospective studies are ongoing to assess the efficacy and toxicity of the Japanese schedule.

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Section: International Commission On Radiation Units and Measurementsmentioning

confidence: 99%

Section: Future Perspectivesmentioning

confidence: 99%

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Current status and perspectives of brachytherapy for cervical cancer

Toita

2009

Int J Clin Oncol

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“…The first cycle of cisplatin was initiated at the first radiotherapy (RT) treatment. In accordance with the duration of RT, the treatment plan included a total of five to six cycles of cisplatin (for further details on drug administration, see Chen et al [13] ).…”

Section: Irradiation Consisted Of External Beam Radiotherapy (Ebrt) Fmentioning

confidence: 99%

Clinical Implications of Elevated Pretreatment Carcinoembryonic Antigen in Patients with Advanced Squamous Cell Carcinoma of the Uterine Cervix

Chen¹,

Liang²,

Hung³

et al. 2008

Tumor Biol

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Object: The aim of this study was to investigate the prognostic significance of pretreatment levels of carcinoembryonic antigen (CEA) for treatment outcome in comparison with squamous cell carcinoma antigen (SCC) in cervical cancer patients following concurrent chemoradiotherapy (CCRT). Methods: A total of 148 patients with stage IB2–IVA squamous cell carcinoma of the uterine cervix who were treated with a full course of CCRT were included for analysis. The pretreatment blood samples of tumor markers were obtained before initiation of CCRT. Values for SCC <2 and CEA <5 ng/ml, respectively, were regarded as normal. Cox’s proportional hazards model was performed for risk stratification for disease-free survival (DFS) and cause-specific survival (CSS). Results: Pretreatment CEA and SCC levels were elevated in 37.2 and 64.2% of the patients, respectively. Positive pelvic lymph node, stage and pretreatment CEA levels >10 ng/ml were three independent prognostic factors for DFS and CSS. The 5-year DFS for the low- and high-CEA groups was 80 and 56%, respectively (p = 0.02, hazard ratio 2.6), whereas the 5-year CSS for the low- and high-CEA groups was 84 and 63%, respectively (p = 0.01, hazard ratio 3.2). Conclusion: Despite lower sensitivity, pretreatment CEA levels >10 ng/ml predict a poor outcome in advanced squamous cell carcinoma of the cervix.

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“…However, hematologic toxicity (HT) is a common adverse effect (1-3) that can lead to delayed or missed chemotherapy cycles and treatment breaks (2,(4)(5)(6), which may ultimately jeopardize disease control (7). Previous studies have found that chemotherapy intensification can improve pathologic response, progression-free survival, and overall survival (1,4,8,9).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Changes in Active Bone Marrow for Cervical Cancer Patients Treated With Concurrent Chemoradiation Therapy

Noticewala

Williamson

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

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SummaryHematologic toxicity (HT) is a common adverse effect in patients with cervical cancer treated with concurrent chemoradiation therapy. In this study, we used 18 F-fluorodeoxyglucose positron emission tomography to quantify changes in functional bone marrow (BM) in unirradiated (extrapelvic) and irradiated (pelvic) BM in cervical cancer patients treated with concurrent chemotherapy of varying intensities. We found that patients have varying Purpose: To quantify longitudinal changes in active bone marrow (ABM) distributions within unirradiated (extrapelvic) and irradiated (pelvic) bone marrow (BM) in cervical cancer patients treated with concurrent chemoradiation therapy (CRT). Methods and Materials: We sampled 39 cervical cancer patients treated with CRT, of whom 25 were treated with concurrent cisplatin (40 mg/m 2 ) and 14 were treated with cisplatin (40 mg/m 2 ) plus gemcitabine (50-125 mg/m 2 ) (C/G). Patients underwent 18 F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and 1.5 to 6.0 months after treatment. ABM was defined as the subvolume of bone with standardized uptake value (SUV) above the mean SUV of the total bone. The primary aim was to measure the compensatory response, defined as the change in the log of the ratio of extrapelvic versus pelvic ABM percentage from baseline to after treatment. We also quantified the change in the proportion of ABM and mean SUV in pelvic and extrapelvic BM using a 2-sided paired t test. Results: We observed a significant increase in the overall extrapelvic compensatory response after CRT (0.381; 95% confidence interval [CI]: 0.312, 0.449) and separately in patients treated with cisplatin (0.429; 95% CI: 0.340, 0.517) and C/G (0.294; 95% CI: 0.186, 0.402). We observed a trend toward higher compensatory response in patients treated with cisplatin compared with C/G (PZ.057). Pelvic ABM percentage

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Concurrent weekly cisplatin plus external beam radiotherapy and high-dose rate brachytherapy for advanced cervical cancer: A control cohort comparison with radiation alone on treatment outcome and complications

Cited by 52 publications

References 24 publications

Current status and perspectives of brachytherapy for cervical cancer

Current status and perspectives of brachytherapy for cervical cancer

Clinical Implications of Elevated Pretreatment Carcinoembryonic Antigen in Patients with Advanced Squamous Cell Carcinoma of the Uterine Cervix

Longitudinal Changes in Active Bone Marrow for Cervical Cancer Patients Treated With Concurrent Chemoradiation Therapy

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