title: Reconsideration of postoperative concurrent chemoradiotherapy with fluorouracil and cisplatin for uterine cervical cancer.
abstract: OBJECTIVE
  The aim of this retrospective study was to analyze data for patients with stage IB-IIB uterine cervical cancer who were treated with concurrent chemoradiotherapy with fluorouracil (5-FU) and cisplatin (CCRT-FP) as postoperative adjuvant therapy and to re-examine these issues and further treatment.
  
  
  METHODS
  Patients with high risk for recurrence underwent CCRT-FP as postoperative adjuvant therapy. A total of 73 patients who met these criteria were included in this study. Data related to survival, toxicity, and treatment feasibility were analyzed, and the question of whether there were differences in survival and toxicity according to the number of dissected lymph nodes at surgery was evaluated.
  
  
  RESULTS
  Median patient age was 45 years (range, 24-67 years). Two-thirds of patients had squamous cell histologic type, 41 patients (56.2%) had parametrial invasion, and 60 patients (82.2%) had lymph node metastases. Estimated 4-year progression-free survival, overall survival, and local control rates were 71.8%, 84.1%, and 88.5%, respectively. Sixteen patients (21.9%) had grade 3-4 neutropenia and one of them died of septic shock. Non-hematological toxicities were also common: 13 (17.8%) experienced grade 3-4 nausea, and nine (12.3%) experienced grade 3-4 diarrhea. Ileus occurred in 17 patients (23.3%), and seven of them (9.6%) were not yet cured. One patient experienced gastrointestinal perforation.
  
  
  CONCLUSIONS
  CCRT-FP in the postoperative setting resulted in good survival outcome but toxicity remained problematic. Development of appropriate treatment for patients with high-risk prognostic factors after radical hysterectomy and lymphadenectomy is required.
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Takekuma
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kasamatsu
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kado
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Kuji
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Abe
authors.affiliation: Shizuoka Cancer Center, Nagaizumi, Shizuoka, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hirashima
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin; D005472:Fluorouracil
keywords: cervical cancer; cisplatin; concurrent chemoradiotherapy; fluorouracil; postoperative adjuvant therapy