title: Results of concurrent chemotherapy and hyperthermia in patients with recurrent cervical cancer after previous chemoradiation.
abstract: BACKGROUND
  Concomitant hyperthermia has been shown to improve response rate after cisplatin in recurrent cervical cancer in previously irradiated patients. It is unclear whether similar response rates can be obtained in patients with a recurrence after previous platinum-containing chemoradiation.
  
  
  OBJECTIVE
  This study aimed to evaluate the outcome of cisplatin-based chemotherapy with concurrent hyperthermia in patients with recurrent cervical cancer after radiotherapy and cisplatin.
  
  
  METHODS
  Patients with recurrent cervical cancer after cisplatin-based chemoradiation or neoadjuvant chemotherapy followed by surgery and radiotherapy who were treated with concurrent platinum-based chemotherapy and hyperthermia were eligible for this retrospective analysis. All patients received six or eight weekly platinum-based chemotherapy cycles in combination with six or eight weekly hyperthermia sessions. The time-to-event variables were estimated using Kaplan-Meier analysis. P-values less than 0.05 were considered significant.
  
  
  RESULTS
  All 38 evaluable patients were selected from the hyperthermia database in the Academic Medical Centre (Amsterdam) and the Erasmus Medical Centre (Rotterdam). Mean age at relapse was 45.7 years (range 27-74). Median time to recurrence after first-line treatment was 15 months. A total of 27 patients had a local and/or regional recurrence; 11 had disease beyond the pelvis. All planned courses of cisplatin chemotherapy and hyperthermia were administered in 17/38 patients. Median follow-up was 6.5 months. One patient died during treatment; response rate was 4/37 (14%), with one complete response. Overall survival was 23% at 12 months and 4% at 24 months. The incidence of grade 3-4 haematological complications did not exceed 10%.
  
  
  CONCLUSIONS
  In this retrospective study, concurrent cisplatin and hyperthermia after first-line cisplatin-containing chemoradiation showed poor response and survival. We do not recommend this treatment for recurrence of locally advanced cervical cancer.
authors.affiliation: Department of Obstetrics and Gynaecology, Erasmus Medical Centre Cancer Institute , Rotterdam .
authors.forename: Sabrina T
authors.initials: ST
authors.lastname: Heijkoop
authors.forename: Helena C
authors.initials: HC
authors.lastname: van Doorn
authors.forename: Lukas J A
authors.initials: LJ
authors.lastname: Stalpers
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Boere
authors.forename: Jacobus
authors.initials: J
authors.lastname: van der Velden
authors.forename: Martine
authors.initials: M
authors.lastname: Franckena
authors.forename: Anneke M
authors.initials: AM
authors.lastname: Westermann
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D002583:Uterine Cervical Neoplasms / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin