title: Postoperative concurrent daily low-dose cisplatin-based chemoradiation improves the prognosis of patients with pathologic T2b or N1 cervical cancer.
abstract: OBJECTIVE
  To determine the effectiveness of postoperative concurrent daily low-dose cisplatin-based chemoradiation (CCRT) in patients with high-risk cervical cancer.
  
  
  METHODS
  Patients with stage IB, IIA, or IIB cervical cancer who were initially treated with radical hysterectomy and pelvic lymphadenectomy, and were proven to have pelvic lymph node metastasis (pN1) or microscopic involvement of the parametrium (pT2b), participated in this study. Thirty-one patients received adjuvant CCRT with daily low-dose (6-8.5 mg/m(2)) cisplatin (daily CCRT group). A non-randomised control group of 44 patients received adjuvant radiotherapy alone (RT group).
  
  
  RESULTS
  Overall survival (OS) at 4 years was 61% in the RT group and 91% in the daily CCRT group (p=0.004). Hazard ratio for poorer recurrence-free survival (RFS) in the RT group vs. the CCRT group was 7.9 (p=0.006). In the daily CCRT group, daily cisplatin chemotherapy was successfully completed in 27 out of 31 patients, although toxicity of grade >or=3 was found in 29% for neutropenia and 17% for gastrointestinal tract toxicity.
  
  
  CONCLUSIONS
  Postoperative adjuvant CCRT with daily low-dose cisplatin improved RFS and OS of pT2b or pN1 patients, with acceptable compliance.
authors.affiliation: Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana Chuo-ku, Chiba 260-8670, Japan. antira@faculty.chiba-u.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Mitsuhashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Uno
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Usui
authors.forename: Shinichi
authors.initials: S
authors.lastname: Tate
authors.forename: Kouichiro
authors.initials: K
authors.lastname: Hirashiki
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kato
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kiyohara
authors.forename: Shinngo
authors.initials: S
authors.lastname: Kato
authors.forename: Hisao
authors.initials: H
authors.lastname: Ito
authors.forename: Makio
authors.initials: M
authors.lastname: Shozu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002945:Cisplatin / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin