Tolerability, Efficacy and Feasibility of Concurrent Gemcitabine and Cisplatin (CGP) Combined With Intensity Modulated Radiotherapy for Loco-Regionally Advanced Carcinoma of the Cervix

Drokow, Emmanuel Kwateng; Li, Zi; Han, Qin; Xu, Lanlan; Foli, Francis; Ahmed, Hafiz Abdul Waqas; Akpabla, Gloria Selorm; Wu, Guangzhi; Agyekum, Emmanuel Bamfo; Gao, Weihua; Deku, Marie-Anne; Song, Jianping; Sun, Kai

doi:10.7150/jca.40276

Cited by 10 publications

(6 citation statements)

References 27 publications

(33 reference statements)

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“…In nine studies, adjuvant systemic therapy consisted of 1–3 cycles cisplatin and a pyrimidine antagonist. This was 5-fluorouracil in five [ 18 , 19 , 22 , 23 , 24 , 35 ], gemcitabine in four studies [ 11 , 20 , 21 , 34 , 37 ]. In 12 studies, adjuvant systemic therapy was 3–6 cycles of a platinum derivate (carboplatin [ 17 , 25 , 27 , 29 , 30 , 31 , 32 , 33 , 40 ], cisplatin [ 49 ], cisplatin or carboplatin [ 28 ] or nedaplatin [ 32 ] with a taxane (paclitaxel in 11 [ 17 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 40 , 50 ], docetaxel in 1 [ 49 ]).…”

Section: Resultsmentioning

confidence: 99%

Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Horeweg

Mittal

Gradowska

et al. 2021

Cancers

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Background: Standard of care for locally advanced cervical cancer is chemoradiation and brachytherapy. The addition of adjuvant systemic treatment may improve overall survival. A systematic review and meta-analysis was conducted to summarize evidence on survival outcomes, treatment completion and toxicity. Methods: PubMed, EMBASE and Web of Science were systematically searched for relevant prospective and retrospective studies. Two authors independently selected studies, extracted data and assessed study quality. Pooled hazard ratios for survival endpoints were estimated using random effect models. Weighted averages of treatment completion and toxicity rates were calculated and compared by the Fisher exact test. Results: The search returned 612 articles; 35 articles reporting on 29 different studies on adjuvant chemotherapy or immunotherapy were selected for systematic review. Twelve studies on an adjuvant platinum–pyrimidine antagonist or platinum–taxane were included for meta-analysis. The pooled hazard ratios for overall survival were 0.76 (99%CI: 0.43–1.34, p = 0.22) and 0.47 (99%CI: 0.12–1.86, p = 0.16) for the addition of, respectively, a platinum–pyrimidine antagonist or platinum–taxane to chemoradiation and brachytherapy. Completion rates were 82% (95%CI: 76–87%) for platinum–pyrimidine antagonist and 74% (95%CI: 63–85%) for platinum–taxane. Severe acute hematological and gastro-intestinal toxicities were significantly increased by adding adjuvant chemotherapy to chemoradiation and brachytherapy. Conclusions: The addition of adjuvant platinum–pyrimidine antagonist or platinum–taxane after chemoradiation and brachytherapy does not significantly improve overall survival, while acute toxicity is significantly increased. These adjuvant treatment strategies can therefore not be recommended for unselected patients with locally advanced cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Horeweg

Mittal

Gradowska

et al. 2021

Cancers

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“…e 5-year overall survival rate for all women with carcinoma of the cervix varies from 56-78% [26][27][28][29]. e 5year OS rate is 78% for women aged 50 years or below.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Variables of Younger-Aged Cervical Carcinoma Patients: A Retrospective Study

Drokow

Akpabla

et al. 2021

Journal of Oncology

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Purpose. The prevalence of carcinoma of the cervix is increasing in younger women. This study aimed to evaluate the sociodemographic, pathological, and clinical features, prognosis, and treatment of women aged ≤35 years with carcinoma of the cervix (CC). Methods and Materials. We retrospectively analysed the clinical information of 352 younger women with carcinoma of the cervix aged ≤35 years at the Gynaecological Oncology Department of Zhengzhou University People’s Hospital from April 2000 to January 2018. The overall survival was evaluated with the Kaplan–Meier model, and the log-ranked analysis was compared with the univariate analysis to determine prognostic survival-related risk factors. Cox Proportional Hazards analysis was further used in analysing parameters correlated with survival after univariate analysis. A p value <0.05 was considered statistically significant. SPSS version 23.0 was used for the data analysis. Results. The most frequent histopathological type observed in the selected 352 younger women was squamous cell carcinoma (SCC) (n = 221, 62.9%), adenocarcinoma (n = 125, 35.5%), and adenosquamous carcinoma (n = 6, 1.7%). The 5-year overall survival time was 80.5%. The prognostic risk factors discovered through univariate analysis were tumour stage (IA1-IIB vs. IIIA-IVA) (89.2% vs. 35.1%: p value = 0.002), histological type (SCC vs. non-SCC) (95.7% vs. 56.2%: p value = 0.001), surgical margin (negative vs. positive) (90.9% vs. 41.2%: p value = 0.001), and pelvic lymph node metastasis (no vs. yes) (93.4% vs. 39.2%: p value = .001). The Cox proportional hazards test demonstrated that lymph node metastases ([HR] = 2.924, 95% CI: 1.432–7.426; p = 0.014 ), tumour stage IIIA-IVA ([HR] = 3.765, 95% CI: 1.398–9.765; p = 0.016 ), and surgical margin ([HR] = 2.167, 95% CI: 1.987–9.554; p = 0.019 ) were independent prognostic risk factors for overall survival in younger women with cervical carcinoma. Conclusion. In conclusion, the status of lymph node metastases, tumour stage, and surgical margin and the type of histopathology substantially influence the rate of survival.

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“…146 stage IB2-stage IIB cervical cancer patients were treated from September 2011-December 2015. The eligibility criteria were [8]:…”

Section: Patient Selectionmentioning

confidence: 99%

Dosimetric Comparison and Clinical Toxicity in Cervical Cancer Patients Treated with Intensity- Modulated and Three-Dimensional Conformal Radiotherapy: Real-World Data

2020

Cancer Stud Ther J

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minimum radiation to healthy organs. This treatment can be noxious, and about 20-25% of patients are reported to have severe side effects [3]. Hence, reliable dose-response knowledge in malignant lesions and organs at risk (OAR) is therefore very vital. Before advancement into new treatment planning and imaging technique, most cervical cancer patients were treated using 2D (Two-dimensional) planning. In 2D treatment planning, the contour of the patient is captured with x-ray using lead wire, and bony landmarks and is transcribed on a graph paper sheet with an identified reference point, [4] which results in the target volume being inadequately uncovered. With the

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Tolerability, Efficacy and Feasibility of Concurrent Gemcitabine and Cisplatin (CGP) Combined With Intensity Modulated Radiotherapy for Loco-Regionally Advanced Carcinoma of the Cervix

Cited by 10 publications

References 27 publications

Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Adjuvant Systemic Therapy after Chemoradiation and Brachytherapy for Locally Advanced Cervical Cancer: A Systematic Review and Meta-Analysis

Prognostic Variables of Younger-Aged Cervical Carcinoma Patients: A Retrospective Study

Dosimetric Comparison and Clinical Toxicity in Cervical Cancer Patients Treated with Intensity- Modulated and Three-Dimensional Conformal Radiotherapy: Real-World Data

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