title: Prognostic significance of neutropenia during adjuvant concurrent chemoradiotherapy in early cervical cancer.
abstract: OBJECTIVE
  To evaluate the prognostic significance of adjuvant concurrent chemoradiotherapy-induced neutropenia with survival in patients with squamous cell carcinoma of the uterine cervix.
  
  
  METHODS
  Data from 107 patients with stage IB-IIB cervical cancer were retrospectively analyzed. The median follow-up was 37.5 (4.2-72.7) months. All patients had received radical surgery, including pelvic lymphadenectomy, followed by paclitaxel plus carboplatin-based concurrent chemoradiotherapy. Relative neutropenia, defined as an absolute neutrophil count <1,000/mm(3) at the concurrent chemoradiotherapy cycle nadir, correlated to the pathologic findings and survival outcomes.
  
  
  RESULTS
  Sixty-six patients experienced neutropenia at least once during concurrent chemoradiotherapy, and demonstrated marginal improvement in disease-free survival (p=0.055), although not in overall survival. By subgroup analyses, the gain of disease free survival mainly originated from the node metastasis subgroup (p=0.033). Treatment-induced neutropenia proved to be the only significant independent factor for recurrence in cervical cancer (p=0.042) by multivariate analysis.
  
  
  CONCLUSIONS
  Concurrent chemoradiotherapy-induced neutropenia may be a prognostic factor of recurrence in patients with cervical cancer. Individualized dose titration of the tolerable myelosuppression might be beneficial.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yun Hwan
authors.initials: YH
authors.lastname: Kim
authors.forename: Hyun Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Jae Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Noh-Hyun
authors.initials: NH
authors.lastname: Park
authors.forename: Yong-Sang
authors.initials: YS
authors.lastname: Song
authors.forename: Soon-Beom
authors.initials: SB
authors.lastname: Kang