Radiotherapy and hyperthermia for treatment of primary locally advanced cervix cancer: results in 378 patients.
OBJECTIVE
To report response rate, pelvic tumor control, survival, and late toxicity after treatment with combined radiotherapy and hyperthermia (RHT) for patients with locally advanced cervical carcinoma (LACC) and compare the results with other published series.


METHODS
From 1996 to 2005, a total of 378 patients with LACC (International Federation of Gynecology and Obstetrics Stage IB2-IVA) were treated with RHT. External beam radiotherapy (RT) was applied to 46-50.4 Gy and combined with brachytherapy. The hyperthermia (HT) was prescribed once weekly. Primary end points were complete response (CR) and local control. Secondary end points were overall survival, disease-specific survival, and late toxicity. Patient, tumor, and treatment characteristics predictive for the end points were identified in univariate and multivariate analyses.


RESULTS
Overall, a CR was achieved in 77% of patients. At 5 years, local control, disease-specific survival, and incidence of late toxicity Common Terminology Criteria for Adverse Events Grade 3 or higher were 53%, 47%, and 12%, respectively. In multivariate analysis, number of HT treatments emerged as a predictor of outcome in addition to commonly identified prognostic factors.


CONCLUSIONS
The CR, local control, and survival rates are similar to previously observed results of RHT in the randomized Dutch Deep Hyperthermia Trial. Reported treatment results for currently applied combined treatment modalities (i.e., RT with chemotherapy and/or HT) do not permit definite conclusions about which combination is superior. The present results confirm previously shown beneficial effects from adding HT to RT and justify the application of RHT as first-line treatment in patients with LACC as an alternative to chemoradiation.
Franckena
Martine
M
Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.
Lutgens
Ludy C
LC
Koper
Peter C
PC
Kleynen
Catharina E
CE
van der Steen-Banasik
Elsbieta M
EM
Jobsen
Jan J
JJ
Leer
Jan Willem
JW
Creutzberg
Carien L
CL
Dielwart
Michel F
MF
van Norden
Yvette
Y
Canters
Richard A M
RA
van Rhoon
Gerard C
GC
van der Zee
Jacoba
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000401:mortality*; D015994:Incidence; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D020266:Radiotherapy, Conformal / Q000401:mortality*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D055815:Young Adult