title: Clinical outcome observation of preoperative concurrent chemoradiotherapy/radiotherapy alone in 174 Chinese patients with local advanced cervical carcinoma.
abstract: OBJECTIVE
  To study outcomes of concurrent chemoradiotherapy (CCRT) or radiotherapy (RT) alone followed by radical surgery in patients with local advanced cervical cancer.
  
  
  METHODS
  A retrospective approach was carried out in 174 Chinese patients with International Federation of Obstetricians and Gynaecologists stage IB2-IIIB cervical carcinoma. A total of 121 patients were treated with CCRT, while the remaining 53 patients received RT alone, and the regimen of chemotherapy was weekly cisplatin (40 mg/m2). Pathological response, overall survival (OS), progression-free survival (PFS), and complications were analyzed.
  
  
  RESULTS
  The median age was 45 years and the mean primary tumor diameter was 4.8 ± 1.0 cm. Pathological complete response (CR) was achieved in 53 patients (30.5%). The CR rate was relatively higher in the CCRT group (31.4% vs 28.3%, P = 0.724), particularly when tumor diameter was less than 5 cm (38.2% vs 30.8%, P = 0.623). With median follow-up of 24 months, patients with CR had improved 3-year OS (100% vs 83.6%, P = 0.018) and 3-year PFS (93.1% vs 83.2%, P = 0.035) compared to patients with residual disease. CCRT was associated with significantly improved 3-year PFS (92.0% vs 76.5%, P = 0.032) compared to RT alone in patients with tumor diameter less than 5 cm. Thirty-seven patients (21.3%) experienced more than grade 2 toxicity, and one patient (0.6%) developed grade 3 uronephrosis. Data thus indicated that pathologic response, tumor size, and lymph-node involvement were highly correlated with clinical outcomes of the local advanced cervical disease.
  
  
  CONCLUSIONS
  Preoperative CCRT achieved outcomes superior to RT alone, depending on the pathologic response, tumor size and lymph-node involvement as major prognostic factors.
authors: Department of Radiation Oncology.
authors: Li-Chun
authors: LC
authors: Wei
authors: Ning
authors: N
authors: Wang
authors: Mei
authors: M
authors: Shi
authors: Jun-Yue
authors: JY
authors: Liu
authors: Jian-Ping
authors: JP
authors: Li
authors: Ying
authors: Y
authors: Zhang
authors: Yan-Hong
authors: YH
authors: Huang
authors: Xia
authors: X
authors: Li
authors: Yan
authors: Y
authors: Chen
keywords: concurrent chemoradiotherapy; local advanced cervical carcinoma; pelvic lymphadenectomy; prognostic factors; radical hysterectomy
references: Cancer Radiother. 2009 Jul;13(4):291-7
references: 19524469
references: Eur J Surg Oncol. 2007 May;33(4):498-503
references: 17156969
references: Int J Radiat Oncol Biol Phys. 2010 Jul 1;77(3):751-7
references: 19836154
references: J Clin Oncol. 2008 Dec 10;26(35):5802-12
references: 19001332
references: Eur J Surg Oncol. 2012 Oct;38(10):948-54
references: 22818842
references: Gynecol Oncol. 2006 Sep;102(3):523-9
references: 16504274
references: Eur J Cancer Care (Engl). 2008 Mar;17(2):174-81
references: 18302655
references: Gynecol Oncol. 2007 Oct;107(1 Suppl 1):S127-32
references: 17727936
references: Radiother Oncol. 1993 Mar;26(3):195-202
references: 8316648
references: Eur J Obstet Gynecol Reprod Biol. 2011 Apr;155(2):188-92
references: 21232839
references: Int J Gynecol Cancer. 2010 Feb;20(2):268-75
references: 20169670
references: Orv Hetil. 2006 Jul 16;147(28):1315-20
references: 16999017
references: Gynecol Oncol. 2005 Dec;99(3 Suppl 1):S166-70
references: 16150482
references: J Clin Oncol. 2011 May 1;29(13):1678-85
references: 21444871
references: Int J Radiat Oncol Biol Phys. 2008 Dec 1;72(5):1508-15
references: 18676093
references: Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1341-6
references: 7713792
references: Anticancer Res. 2003 May-Jun;23(3C):2885-90
references: 12926129
references: Gynecol Oncol. 2009 Sep;114(3):404-9
references: 19555996
references: Gynecol Oncol. 2012 Jan;124(1):63-7
references: 22004904
references: J Clin Oncol. 2000 Apr;18(8):1606-13
references: 10764420
references: N Engl J Med. 1999 Apr 15;340(15):1154-61
references: 10202166
references: N Engl J Med. 1999 Apr 15;340(15):1137-43
references: 10202164
references: Anticancer Res. 2011 Apr;31(4):1437-41
references: 21508399
references: CA Cancer J Clin. 2005 Jan-Feb;55(1):10-30
references: 15661684
references: Ann Surg. 2004 Aug;240(2):205-13
references: 15273542
references: Int J Radiat Oncol Biol Phys. 2011 Jun 1;80(2):429-36
references: 20542643
references: Int J Radiat Oncol Biol Phys. 2005 Dec 1;63(5):1604-12
references: 16198509
references: N Engl J Med. 1999 Apr 15;340(15):1198-200
references: 10202172
references: Gynecol Oncol. 2010 Aug 1;118(2):128-33
references: 20494419