title: Outcomes in 24 selected patients with stage IVB cervical cancer and excellent performance status treated with radiotherapy and chemotherapy.
abstract: OBJECTIVE
  We sought to review outcomes in patients with stage IVB carcinoma of the cervix treated with irradiation in combination with chemotherapy.
  
  
  METHODS
  We report outcomes of 24 consecutive patients with good performance status treated from 1998 to 2005. Most of these patients underwent concurrent irradiation with platinum-based chemotherapy. Some patients received subsequent systemic chemotherapy.
  
  
  RESULTS
  All patients underwent external beam radiotherapy; 7 patients (29%) had additional high-dose-rate and 12 (50%) low-dose-rate brachytherapy. Two patients (8%) received an IMRT boost instead of brachytherapy. The mean dose to point A was variable (73.9 +/- 19.2 Gy). Twenty patients (83%) received radio-sensitizing platinum-based chemotherapy, and the remaining had radiotherapy alone. Seven patients (29%) had further combination chemotherapy. Therapy was well tolerated. The overall survival was 44% at 36 months and 22% at 5 years.
  
  
  CONCLUSIONS
  Patients with stage IVB cervical cancer have mostly been treated with palliative intent. With the advent of concurrent chemoradiation, we have treated many of these cases with aggressive combination therapy. In this series, the use of radiotherapy and multiagent chemotherapy in patients with stage IVB cervical carcinoma and good performance status was well tolerated and resulted in higher survival rates than previously reported.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St. Louis, MO, USA. zighelboimi@wustl.edu
authors.forename: Israel
authors.initials: I
authors.lastname: Zighelboim
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Taylor
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Powell
authors.forename: Randall K
authors.initials: RK
authors.lastname: Gibb
authors.forename: Janet S
authors.initials: JS
authors.lastname: Rader
authors.forename: David G
authors.initials: DG
authors.lastname: Mutch
authors.forename: Perry W
authors.initials: PW
authors.lastname: Grigsby
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001918:Brachytherapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D017671:Platinum Compounds / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D017671:Platinum Compounds