title: Evaluation of Outcomes in Patients With Carcinoma of the Cervix Treated With Concurrent Radiation and Cisplatin Versus Cisplatin/5-FU Compared With Radiation Alone.
abstract: OBJECTIVE
  The objective of this study was to compare outcomes for patients with cervical cancer treated with radiation concurrently with cisplatin, cisplatin/5-fluorouracil (5-FU), or without chemotherapy.
  
  
  METHODS
  We reviewed the records of eligible patients with locoregionally confined, stage IB1 through IVA, intact cervical cancer who were treated at Northwestern Memorial Hospital. All patients underwent definitive radiotherapy with combined external beam radiation-the majority with extended-field (62%)-and received low-dose rate brachytherapy.
  
  
  RESULTS
  A total of 236 patients were included: 99 had no concurrent chemotherapy, 95 were treated with concurrent cisplatin, and 42 were treated with cisplatin/5-FU. For all patients treated with or without chemotherapy, overall survival at 5 and 10 years was 64% and 59%, respectively. Patients treated with chemotherapy had a superior recurrence-free survival rate of 69% at 5 years versus 49% in patients who did not receive chemotherapy (P=0.09). Twenty-six percent of patients treated with cisplatin alone, 31% of patients treated with cisplatin/5-FU, and 45% of patients who did not receive chemotherapy experienced a disease recurrence. Adenosquamous histology conferred a higher rate of recurrence as compared with adenocarcinoma and squamous cell histologies (54% vs. 34%, respectively; P=0.05).
  
  
  CONCLUSIONS
  Cisplatin-based concurrent chemoradiotherapy showed a trend toward improved recurrence-free survival survival in the definitive treatment of nonmetastatic cervical cancer. The addition of 5-FU to cisplatin did not appear to significantly impact survival or recurrence-free survival. Adenosquamous histology was associated with a higher risk of recurrence as compared with other histologic subtypes.
authors.affiliation: Departments of *Radiation Oncology ‡Preventive Medicine §Obstetrics and Gynecology, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL †Department of Clinical Oncology, Alexandria University, Alexandria, Egypt.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Donnelly
authors.forename: Tamer
authors.initials: T
authors.lastname: Refaat
authors.forename: Michelle
authors.initials: M
authors.lastname: Gentile
authors.forename: Alex
authors.initials: A
authors.lastname: Herskovic
authors.forename: John
authors.initials: J
authors.lastname: Boyle
authors.forename: Irene
authors.initials: I
authors.lastname: Helenowski
authors.forename: Alfred
authors.initials: A
authors.lastname: Rademaker
authors.forename: John
authors.initials: J
authors.lastname: Lurain
authors.forename: Julian
authors.initials: J
authors.lastname: Schink
authors.forename: Diljeet
authors.initials: D
authors.lastname: Singh
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Strauss
authors.forename: William
authors.initials: W
authors.lastname: Small
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D002945:Cisplatin; D005472:Fluorouracil