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

Miše, Branka Petrić; Jelavić, Tihana Boraska; Strikić, Ante; Hrepić, Darijo; Tomić, Krešimir; Hamm, Wolfgang; Tomić, Snježana; Prskalo, Tomislav; Vrdoljak, Eduard

doi:10.1097/igc.0000000000000336

Cited by 19 publications

(8 citation statements)

References 23 publications

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“…Petrić Miše et al 11 and Jelavić et al 12 reported encouraging results of four adjuvant cycles of cisplatin and ifosfamide chemotherapy after completion of concurrent chemoradiotherapy in an attempt to improve distant-relapse–free survival. In a randomized trial, Wong et al 13 showed improvement in overall survival after administration of adjuvant chemotherapy with epirubicin at 90 mg/m 2 compared with pelvic radiotherapy and no additional chemotherapy.…”

Section: Resultsmentioning

confidence: 99%

Chemoradiation and the Role of Adjuvant Chemotherapy in Lymph Nodal–Metastatic Cervical Cancer

Nasir

Valimohammad

Abbası

et al. 2018

JGO

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PurposeTo report the long-term outcome in lymph nodal–metastatic cervical squamous cell cancer after chemoradiation followed by adjuvant chemotherapy.Patients and MethodsBetween 2010 and 2013, five patients were diagnosed with advanced cervical cancer with clinically involved para-aortic lymph nodes (ie, International Federation of Gynecology and Obstetrics stage IVB). These patients were treated with concurrent chemoradiation therapy followed by adjuvant chemotherapy. Concurrent chemoradiation consisted of cisplatin given once per week concomitantly with extended-field radiation therapy followed by high-dose-rate brachytherapy. Adjuvant chemotherapy comprised four courses of carboplatin and paclitaxel given every three weeks. The primary outcomes were local and distant failures.ResultsNone of the patients had local recurrence or distal failure after a minimum follow-up time of 3 years.ConclusionAdjuvant chemotherapy after chemoradiation has a probable role in the management of lymph nodal–metastatic cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Chemoradiation and the Role of Adjuvant Chemotherapy in Lymph Nodal–Metastatic Cervical Cancer

Nasir

Valimohammad

Abbası

et al. 2018

JGO

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“…However, these indicators are not definitive criteria for determining which patients respond to CCRT and which patients need further treatment. Confirming worse survival patients during treatment by the response to CCRT may be predicted earlier and alternative initial treatment schedule ( 23 , 24 ). Therefore, some indicators that can be measured by MRI easily and non-invasively during the treatment, such as TVRR, have received increasing attention from researchers.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Tumor Size, Volume and Tumor Volume Reduction Rate During Concurrent Chemoradiotherapy in Patients With Cervical Cancer

Sun

Wang

et al. 2022

Front. Oncol.

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ObjectiveThis study aimed to investigate the relationship between prognostic and tumor parameters of cervical cancer patients, such as tumor size (TS), tumor volume (TV), and tumor volume reduction rate (TVRR) after external beam radiotherapy.MethodsA total of 217 patients with advanced cervical cancer, classified as Federation of Gynecology and Obstetrics (FIGO) IIa–IVa, were enrolled in the study. Pre- and mid-RT pelvic magnetic resonance imaging (MRI) were performed twice, during RT and just before brachytherapy.ResultsThe median follow-up time was 51 months (range, 7–111 months). The 5-year overall survival (OS), progression-free survival (PFS), and local failure-free survival (LFFS) rates were 81.3, 85.1, and 92.9%, respectively. Multivariate analysis revealed that tumor parameters including FIGO stage >II (Hazard Ratio, 2.377 and 95% confidence interval [CI], 1.091–5.182; P = 0.029), pre-RT TV >61.6 cm3 (HR, 0.417 and 95% CI, 0.188–0.926; P = 0.032), and mid-RT TV >11.38 cm3 (HR, 3.192 and 95% CI, 1.094–9.316; P = 0.034) were observably associated with OS. Univariate analysis showed that the tumor volume reduction rate (TVRR) was dramatically associated with overall survival (HR, 0.204 and 95% CI 0.033–1.282; P <0.001) and local failure-free survival (P = 0.050).ConclusionsIn this retrospective study, TVRR and mid-radiotherapy tumor volume are independent and strong prognostic parameters for patients with local advanced cervical cancer receiving CCRT.

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“…Although poorer prognosis in patients with certain conditions, such as large tumor size, adenocarcinoma, or positive PLN metastasis after primary surgery, have been reported [4,7], there are no confirmed criteria for determining which patients need additional treatment; nor is there enough evidence to alter recent treatment guidelines for high-risk patients. Nevertheless, previous studies of patents with locally advanced cervical cancer, from our center and others, have consistently reported that consolidation chemotherapy after primary CCRT might enhance local control and eradicate distant micrometastases [20-23]. A phase-II study that enrolled high-risk early-stage cervical cancer patients as well as locally advanced patients concluded that consolidation chemotherapy had low efficacy [24].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

et al. 2017

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PurposeThe purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease.Materials and MethodsWe retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery.ResultsWe reviewed 247 patients—149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0–3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates.ConclusionIn the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

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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

Abstract: Chemobrachyradiotherapy regimen followed by consolidation chemotherapy described in this article is a valuable treatment option for LACC.

Cited by 19 publications

References 23 publications

Chemoradiation and the Role of Adjuvant Chemotherapy in Lymph Nodal–Metastatic Cervical Cancer

Chemoradiation and the Role of Adjuvant Chemotherapy in Lymph Nodal–Metastatic Cervical Cancer

The Prognostic Value of Tumor Size, Volume and Tumor Volume Reduction Rate During Concurrent Chemoradiotherapy in Patients With Cervical Cancer

Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

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