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Efficacy and prognostic factors of concurrent chemoradiotherapy in patients with stage Ib3 and IIa2 cervical cancer
Affiliations- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 17 Qihelou Street, Dongcheng District, Beijing 100006, China, 100006 Beijing, China
- Liaocheng People’s Hospital, China
open access
Abstract
Objectives: We investigated the efficacy, side effects, and prognostic factors of concurrent chemoradiotherapy for patients
with stage Ib3-IIa2 cervical cancer.
Material and methods: We conducted a retrospective analysis of clinicopathologic data from 73 patients with stage
Ib3-IIa2 cervical cancer who received concurrent chemoradiotherapy from January 2008 to December 2013 in our hospital.
Overall response and disease control rates were used to evaluate short-term outcomes; the 3-year and 5-year disease-free
survival and overall survival were used to evaluate long-term efficacy. Toxicity reactions and prognostic factors were recorded.
Results: With concurrent chemoradiotherapy, overall response and disease control rates were 91.78% and 97.26%, respectively.
The 3-year disease-free and overall survival were 80.82% and 83.56%; the 5-year disease-free and overall survival were 75.34%
and 79.45%, respectively. All side effects were tolerated and potentially alleviated by symptomatic treatment. Tumor pathological
type, differentiated degree, primary tumor size and squamous cell carcinoma antigen levels before and after treatment were
closely related to survival (univariate analysis; p < 0.05). Pathological type, primary tumor size and squamous cell carcinoma
antigen levels one month after treatment were independent prognostic factors for long-term outcome (multivariate analysis).
Conclusions: Short- and long-term efficacy of concurrent chemoradiotherapy for stage Ib3-IIa2 cervical cancer is well-determined
and tolerable. Patients with adenocarcinomas, tumor diameter ≥ 5 cm and squamous cell carcinoma antigen
levels ≥ 1.5 ng/mL (one month after treatment) had poor prognosis and should be assessed further.
Abstract
Objectives: We investigated the efficacy, side effects, and prognostic factors of concurrent chemoradiotherapy for patients
with stage Ib3-IIa2 cervical cancer.
Material and methods: We conducted a retrospective analysis of clinicopathologic data from 73 patients with stage
Ib3-IIa2 cervical cancer who received concurrent chemoradiotherapy from January 2008 to December 2013 in our hospital.
Overall response and disease control rates were used to evaluate short-term outcomes; the 3-year and 5-year disease-free
survival and overall survival were used to evaluate long-term efficacy. Toxicity reactions and prognostic factors were recorded.
Results: With concurrent chemoradiotherapy, overall response and disease control rates were 91.78% and 97.26%, respectively.
The 3-year disease-free and overall survival were 80.82% and 83.56%; the 5-year disease-free and overall survival were 75.34%
and 79.45%, respectively. All side effects were tolerated and potentially alleviated by symptomatic treatment. Tumor pathological
type, differentiated degree, primary tumor size and squamous cell carcinoma antigen levels before and after treatment were
closely related to survival (univariate analysis; p < 0.05). Pathological type, primary tumor size and squamous cell carcinoma
antigen levels one month after treatment were independent prognostic factors for long-term outcome (multivariate analysis).
Conclusions: Short- and long-term efficacy of concurrent chemoradiotherapy for stage Ib3-IIa2 cervical cancer is well-determined
and tolerable. Patients with adenocarcinomas, tumor diameter ≥ 5 cm and squamous cell carcinoma antigen
levels ≥ 1.5 ng/mL (one month after treatment) had poor prognosis and should be assessed further.
Keywords
concurrent chemoradiotherapy; efficacy; locally advanced cervical cancer; prognostic; retrospective
About this articleTitle
Efficacy and prognostic factors of concurrent chemoradiotherapy in patients with stage Ib3 and IIa2 cervical cancer
Journal
Issue
Article type
Research paper
Pages
57-61
Published online
2020-02-28
Page views
1842
Article views/downloads
1000
DOI
Pubmed
Bibliographic record
Ginekol Pol 2020;91(2):57-61.
Keywords
concurrent chemoradiotherapy
efficacy
locally advanced cervical cancer
prognostic
retrospective
Authors
Tingting Liu
Weimin Kong
Yao Liu
Dan Song
References (18)- Verma J, Monk BJ, Wolfson AH. New Strategies for Multimodality Therapy in Treating Locally Advanced Cervix Cancer. Semin Radiat Oncol. 2016; 26(4): 344–348.
- Zhao H, He Y, Yang SL, et al. Neoadjuvant chemotherapy with radical surgery vs radical surgery alone for cervical cancer: a systematic review and meta-analysis. Onco Targets Ther. 2019; 12: 1881–1891.
- NCCN Guidelines Version 3.2019 [s]. Panel Members-Uterine Neoplasms. http://www.nccn.org/professionals/physician-gls/pdf/uterine.pdf.
- Beránek M, Drastíková M, Paulíková S, et al. Analysis of D1853N ATM polymorphism in radiosensitive patients with cervical carcinoma. Acta Medica (Hradec Kralove). 2011; 54(3): 111–116.
- Cohen P, Jhingran A, Oaknin A, et al. Cervical cancer. The Lancet. 2019; 393(10167): 169–182.
- Kokka F, Bryant A, Brockbank E, et al. Hysterectomy with radiotherapy or chemotherapy or both for women with locally advanced cervical cancer. Cochrane Database Syst Rev. 2015.
- Chen CC, Wang L, Lin JC, et al. The prognostic factors for locally advanced cervical cancer patients treated by intensity-modulated radiation therapy with concurrent chemotherapy. J Formos Med Assoc. 2015; 114(3): 231–237.
- Zhang T, Kong W, Li F, et al. Effect of preoperative radiotherapy on stage IB2 and IIA2 cervical cancer: A retrospective cohort study. Int J Surg. 2016; 30: 63–67.
- Datta NR, Stutz E, Liu M, et al. Concurrent chemoradiotherapy vs. radiotherapy alone in locally advanced cervix cancer: A systematic review and meta-analysis. Gynecol Oncol. 2017; 145(2): 374–385.
- Minig L, Patrono MG, Romero N, et al. Different strategies of treatment for uterine cervical carcinoma stage IB2-IIB. World J Clin Oncol. 2014; 5(2): 86–92.
- Li R, Liu GZ, Luo SY, et al. Cyclin I promotes cisplatin resistance via Cdk5 activation in cervical cancer. Eur Rev Med Pharmacol Sci. 2015; 19(23): 4533–4541.
- Vordermark D. Radiotherapy of Cervical Cancer. Oncol Res Treat. 2016; 39(9): 516–520.
- Fabri VA, Queiroz ACM, Mantoan H, et al. The Impact of Addition of Consolidation Chemotherapy to Standard Cisplatin-Based Chemoradiotherapy in Uterine Cervical Cancer: Matter of Distant Relapse. J Oncol. 2019; 2019: 1217838.
- Dang YZ, Li P, Li JP, et al. Efficacy and Toxicity of IMRT-Based Simultaneous Integrated Boost for the Definitive Management of Positive Lymph Nodes in Patients with Cervical Cancer. J Cancer. 2019; 10(5): 1103–1109.
- Gondi V, Bentzen SM, Sklenar KL, et al. Severe late toxicities following concomitant chemoradiotherapy compared to radiotherapy alone in cervical cancer: an inter-era analysis. Int J Radiat Oncol Biol Phys. 2012; 84(4): 973–982.
- Kim TE, Park BJ, Kwack HS, et al. Outcomes and prognostic factors of cervical cancer after concurrent chemoradiation. J Obstet Gynaecol Res. 2012; 38(11): 1315–1320.
- Endo D, Todo Y, Okamoto K, et al. Prognostic factors for patients with cervical cancer treated with concurrent chemoradiotherapy: a retrospective analysis in a Japanese cohort. J Gynecol Oncol. 2015; 26(1): 12–18.
- Queiroz AC, Fabri V, Mantoan H, et al. Risk factors for pelvic and distant recurrence in locally advanced cervical cancer. Eur J Obstet Gynecol Reprod Biol. 2019; 235: 6–12.
