title: First results of triple-modality treatment combining radiotherapy, chemotherapy, and hyperthermia for the treatment of patients with stage IIB, III, and IVA cervical carcinoma.
abstract: BACKGROUND
  Patients with advanced cervical carcinoma are treated routinely with radiotherapy and cisplatin-containing chemotherapy. It has been shown that hyperthermia can improve the results of both radiotherapy and cisplatin. In the current study, the feasibility and efficacy of the combination of all three modalities was studied in previously untreated patients with cervical carcinoma.
  
  
  METHODS
  Patients with advanced cervical carcinoma were registered prospectively in the U.S., Norway, and the Netherlands. External-beam radiotherapy and brachytherapy were administered for a biologically effective dose > or = 86.7 gray. At least 4 courses of weekly cisplatin (40 mg/m(2)) and 4 sessions of weekly locoregional hyperthermia were added to radiotherapy.
  
  
  RESULTS
  Sixty-eight patients with a median age of 45 years were enrolled. Full-dose radiotherapy was delivered to all patients according to plan. At least 4 courses of chemotherapy were received by 97% of patients, and at least 4 courses of hyperthermia treatment were received by 93% of patients. Toxicity was fully comparable to that described for chemoradiotherapy alone, and the median total treatment time was 45 days. Complete remission was achieved by 61 patients (90%). After a median follow-up of 538 days, 74% of patients remained alive without signs of recurrence, and the overall survival rate was 84%.
  
  
  CONCLUSIONS
  The combination of full-dose radiotherapy, chemotherapy, and hyperthermia was feasible and effective in a multicenter international setting among patients with advanced cervical carcinoma. A Phase III study comparing this novel triplet with standard chemoradiation, designed to show at least a 15% improvement in overall survival, has been launched.
authors.affiliation: Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands. a.m.westermann@amc.uva.nl
authors.forename: Anneke M
authors.initials: AM
authors.lastname: Westermann
authors.forename: Ellen L
authors.initials: EL
authors.lastname: Jones
authors.forename: Baard-Christian
authors.initials: BC
authors.lastname: Schem
authors.forename: Elzbieta M
authors.initials: EM
authors.lastname: van der Steen-Banasik
authors.forename: Peter
authors.initials: P
authors.lastname: Koper
authors.forename: Olav
authors.initials: O
authors.lastname: Mella
authors.forename: Apollonia L J
authors.initials: AL
authors.lastname: Uitterhoeve
authors.forename: Ronald
authors.initials: R
authors.lastname: de Wit
authors.forename: Jacobus
authors.initials: J
authors.lastname: van der Velden
authors.forename: Curt
authors.initials: C
authors.lastname: Burger
authors.forename: Clasina L
authors.initials: CL
authors.lastname: van der Wilt
authors.forename: Olav
authors.initials: O
authors.lastname: Dahl
authors.forename: Leonard R
authors.initials: LR
authors.lastname: Prosnitz
authors.forename: Jacoba
authors.initials: J
authors.lastname: van der Zee
mesh_terms: D000328:Adult; D000368:Aged; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008875:Middle Aged; D011878:Radiotherapy; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000628:therapy*
chemical_list: D002945:Cisplatin