Concurrent Weekly Nedaplatin, External Beam Radiotherapy and High-Dose-Rate Brachytherapy in Patients with FIGO Stage IIIb Cervical Cancer: A Comparison with a Cohort Treated by Radiotherapy Alone

Abstract

Objectives: The aim of this study was to evaluate whether nedaplatin-based concurrent chemoradiotherapy (CCRT) using high-dose-rate intracavitary brachytherapy (HDR-ICBT) is superior to radiotherapy (RT) alone in patients with FIGO stage IIIb cervical cancer. Methods: The records of 41 consecutive women treated either with nedaplatin-based CCRT using HDR-ICBT (n = 20) or RT alone (nonrandomized control group, n = 21) for stage IIIb cervical cancer were retrospectively reviewed. The activity and toxicity were compared between the two treatment groups. Progression-free survival (PFS) and overall survival (OS) were the main endpoints. Results: The 5-year overall survival rates in the CCRT and RT groups were 65 and 33.3%, respectively. The median OS of the CCRT and RT groups were 60 and 29 months, respectively. CCRT was significantly superior to RT alone with regard to PFS (p = 0.0015) and OS (p = 0.0364). The frequency of acute grade 3–4 toxicity was significantly higher in the CCRT group than in the RT group. However, no statistically significant difference was observed with regard to severe late toxicity. Conclusions: Nedaplatin-based concurrent chemoradiotherapy was safely performed and significantly improved the prognosis of patients with FIGO stage IIIb cervical cancer. This treatment can be considered as an alternative to cisplatin-based chemoradiotherapy in this patient population.

High Dose Rate Cobalt-60 After Loading Intracavitary Therapy of the Uterine Cervical Carcinoma in Srinagarind Hospital, Analysis of Residual Disease

“…In reference to the radiotherapy and hyperthermia modality, the complete response rate for advanced cervix cancer was 77% (Franckena et al, 2009). Additionally, treatment failure in stage IIIB cervical cancer from the study of Mabuchi et al was between 35-66.7% (Mabuchi et al, 2010).…”

Possible Risk Factors Associated with Radiation Proctitis or Radiation Cystitis in Patients with Cervical Carcinoma after Radiotherapy

“…Combinational therapy of HDRICB and EBRT has been widely used for the treatment of cervical carcinoma (Kapp et al, 1997;Mabuchi et al, 2010;Niibe et al, 2010). However, complications, including radiation proctitis and radiation cystitis, commonly occur following irradiation.…”

“…High-dose-rate intracavitary brachy therapy (HDRICB) combined with external beam radiotherapy (EBRT) showed various advantages for the management of cervical carcinoma, including elimination of personnel exposure and short treatment time with the possibility of maintaining exact applicator geometry. Therefore, this therapy combination is widely applied in Japan and parts of Europe (Kapp et al, 1997;Mabuchi et al, 2010;Niibe et al, 2010).…”

What Is the Role of Cytotoxic Chemotherapy in Advanced Cervical Cancer?

“…Nedaplatin (cis-diammine-glycoplatinum) is a derivative of cisplatin developed in Japan. Different small series have demonstrated that this agent appears to have similar effi cacy with lower renal and gastrointestinal toxicities compared to cisplatin [ 40 ]. Performance of non-inferiority randomized trial with nedaplatin could help identify less toxic chemoradiation regimens.…”