Extended-field radiotherapy and high-dose-rate brachytherapy with concurrent and adjuvant cisplatin-based chemotherapy for locally advanced cervical cancer: a phase I/II study

Chung, Yih-Lin; Jian, James Jer-Min; Cheng, Skye Hongiun; Hsieh, Cheng-I; Tan, Tran-Der; Chang, Hui-Ju; Hung, Chi‐Feng; Horng, Cheng-Fang; Soong, Thomas C.; Tsou, Mei-Hua

doi:10.1016/j.ygyno.2004.12.039

Cited by 58 publications

(43 citation statements)

References 34 publications

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“…The present study revealed that 2/48 patients (4.2%) developed grade 3 GI late toxicity. The current results are consistent with reports from these prior studies (7,(27)(28)(29)(30)(31).…”

supporting

confidence: 93%

Extended field intensity-modulated radiotherapy plus concurrent nedaplatin treatment in cervical cancer

Liu

Qian

et al. 2016

Oncology Letters

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Abstract. The present study assessed the efficacy and toxicity of definitive extended-field intensity-modulated radiotherapy (EF-IMRT) plus concurrent chemotherapy in cervical cancer. A total of 48 patients with cervical cancer received the planning target volume between 39.6 and 50.4 Gy in 1.8-2.0 Gy daily fractions, while the enlarged pelvic and/or para-aortic nodes were treated with a total dose of 55-60 Gy in 2.0-2.4 Gy daily fractions using simultaneous integrated boost-IMRT. All patients underwent high dose-rate brachytherapy. Concurrent to EF-IMRT, nedaplatin was administered weekly at a median dose of 30 mg/m 2 (range, 25-40 mg/m 2 ) for 5 weeks with a total of 150 mg/m 2 . Of the 48 patients, 46 patients exhibited initial complete responses and 2 patients had partial responses, with a response rate of 100%. After 4-24 months of treatment, 12 patients (27.08%) had local and/or distant failure and 39 patients (81.25%) were alive at the last follow-up. The 12-month overall survival (OS) and disease-free survival (DFS) were 87.5 and 75.8%, respectively, while the 24-month OS and DFS were 69.7 and 49.7%, respectively. Grade ≥3 acute neutropenia and thrombcytopenia occurred in 20 (41.7%) and 4 (8.3%) patients, respectively, while 2 patients (4.2%) developed grade ≥3 diarrhea and 2 (4.2%) had grade ≥3 late toxicities. However, no patients exhibited grade ≥3 vomiting. Thus, concurrent nedaplatin chemotherapy with definitive EF-IMRT was effective and relatively safe for treating patients with cervical cancer. Furthermore, EF-IMRT was able to deliver ≤60 Gy to enlarged para-aortic and/or pelvic nodes using simultaneous integrated boost without increased acute and late gastrointestinal toxicity.

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“…The present study revealed that 2/48 patients (4.2%) developed grade 3 GI late toxicity. The current results are consistent with reports from these prior studies (7,(27)(28)(29)(30)(31).…”

supporting

confidence: 93%

Extended field intensity-modulated radiotherapy plus concurrent nedaplatin treatment in cervical cancer

Liu

Qian

et al. 2016

Oncology Letters

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“…The incidence and effects from radiotherapy are primarily contingent upon the type of radiation, the amount of exposure, and the fields selected [18]. In particular, radiotherapy-induced symptoms effectuate extensive and premature vasculature damage, compromised tissue circulation, accelerated arteriosclerosis, and blood vessel scarring or necrosis.…”

Section: Discussionmentioning

confidence: 99%

Acute and Delayed Complications from Surgery and Adjuvant Radiotherapy in the Treatment of High-Risk Endometrial Cancer

et al. 2011

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Objectives: This retrospective study assessed the number and type of complications following surgery and adjuvant radiotherapy in the treatment of high-risk endometrial cancer. Methods: Endometrial cancer patients who received surgery and postoperative radiotherapy (pelvic radiotherapy and/or vaginal brachytherapy) from April 1997 until October 2010 were evaluated. Short-term (≤6 months) and long-term (>6 months) complications (e.g., genitourinary/gastrointestinal complications) were comprehensively reviewed. Results: We identified 109 high-risk endometrial cancer patients who completed adjuvant radiotherapy following either a total abdominal hysterectomy (TAH; n = 53) or minimally invasive hysterectomy (MIS; n = 56). The combined impact of surgery and radiotherapy on complication type did not reach statistical significance (p > 0.05). However, surgery type and the development of a complication were significantly related (p < 0.001). The MIS patients developed complications at a more accelerated rate compared to the TAH patients (21 vs. 45 months), although the incidence of toxicity of grade 3 or 4 was much higher in the TAH group. Conclusions: The impact of MIS and adjuvant radiotherapy may have adversely affected the development of complications compared to TAH patients who received adjuvant radiotherapy, although higher-grade patient toxicity was more prevalent in the TAH group.

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“…Since only a few small series have been published that describe CCRT with HDR-ICBT [33][34][35][36][37] , it is difficult to estimate the precise incidence of complications. In the current study, grade 3-4 acute toxicities were observed in 50% of patients, which was similar to the findings of a recent phase II study of nedaplatin-based chemoradiotherapy [22] .…”

Section: Discussionmentioning

confidence: 99%

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

Mabuchi¹,

Ugaki²,

Isohashi

et al. 2010

Gynecol Obstet Invest

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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.

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Extended-field radiotherapy and high-dose-rate brachytherapy with concurrent and adjuvant cisplatin-based chemotherapy for locally advanced cervical cancer: a phase I/II study

Cited by 58 publications

References 34 publications

Extended field intensity-modulated radiotherapy plus concurrent nedaplatin treatment in cervical cancer

Extended field intensity-modulated radiotherapy plus concurrent nedaplatin treatment in cervical cancer

Acute and Delayed Complications from Surgery and Adjuvant Radiotherapy in the Treatment of High-Risk Endometrial Cancer

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

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