Long-term survival data of triple modality treatment of stage IIB-III-IVA cervical cancer with the combination of radiotherapy, chemotherapy and hyperthermia - an update.
BACKGROUND
Advanced cervical cancer is routinely treated with radiotherapy and cisplatin-containing chemotherapy. Hyperthermia has been shown to improve the results of both radiotherapy and cisplatin. The feasibility of the combination of all three modalities was demonstrated and reported in a study of 68 previously untreated cervical cancer patients in 2005. Long-term follow-up is presented here.


METHODS
Sixty-eight patients with advanced cervical cancer were prospectively registered in the USA, Norway and the Netherlands, and treated with a combination of radiotherapy (external beam radiotherapy and brachytherapy for a biologically effective dose of at least 86.7 Gy), chemotherapy (at least four courses of weekly cisplatin (40 mg/m(2))) and locoregional hyperthermia (four weekly sessions). Long-term follow-up was gathered and recurrence-free survival (RFS) and overall survival (OS) curves and survival estimates were obtained.


RESULTS
Median follow-up was 81 months. Tumours in 28 patients have recurred, 21 of whom have died. Five-year RFS from the day of registration in the study is 57.5% (95%CI: 46.6-71.0) and five-year OS is 66.1% (95%CI: 55.1-79.3). Differences between countries can be explained by patient characteristics.


CONCLUSIONS
The long-term survival results of the combination of full-dose radiotherapy, chemotherapy and hyperthermia fall well within previous reports for this patient group in randomised trials. The small trial size and lack of randomisation do not permit further interpretation.
Academic Medical Centre, Amsterdam, the Netherlands. a.m.westermann@amc.uva.nl
Anneke
A
Westermann
Olav
O
Mella
Jacoba
J
Van Der Zee
Ellen L
EL
Jones
Elzbieta
E
Van Der Steen-Banasik
Peter
P
Koper
Appolonia L J
AL
Uitterhoeve
Ronald
R
De Wit
Jacobus
J
Van Der Velden
Curt
C
Burger
Baard-Christian
BC
Schem
Cl
C
Van Der Wilt
Olav
O
Dahl
Leonard R
LR
Prosnitz
Harm
H
Van Tinteren
D000328:Adult; D001918:Brachytherapy / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D009364:Neoplasm Recurrence, Local; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000628:therapy*
D002945:Cisplatin