title: Chemotherapy versus radiotherapy for FIGO stages IB1 and IIA1 cervical carcinoma patients with postoperative isolated deep stromal invasion: a retrospective study.
abstract: The adjuvant treatment for patients with isolated stromal invasion after radical hysterectomy and pelvic lymph node dissection (PLND) in FIGO stage IB1 and IIA1 cervical carcinoma has not been established. This study assessed the survival outcomes and recurrent patterns in this particular group of patients treated with chemotherapy or radiation-based adjuvant therapy.
  
  
  
  The records 133 IB1 and IIA1 postoperative cervical carcinoma patients with histopathology-confirmed isolated deep stromal invasion (DSI) without any other unfavorable pathological finding between June 2010 and March 2013 were analyzed. Sixty-five patients received postoperative adjuvant four to six cycles of cisplatin-based chemotherapy (CT group) and Sixty-eight received postoperative received postoperative adjuvant radiotherapy (RT group). Treatment-related toxicities were evaluated and disease-free survival (DFS) and overall survival (OS) were analyzed using Kaplan-Meier estimates and statistical significance was determined using the log-rank test.
  
  
  
  With a median follow-up of 33.7 months (range 10-62 months), RT group had a significantly improved in DFS rate (P = 0.044), but there was no significant difference in overall survival (P = 0.437). Upon further analysis, patients with outer 1/3 to full-thickness invasion in chemotherapy group exhibited significantly higher recurrence rates compared to the radiotherapy group. Leukocytopenia, nausea and vomiting were the most frequent short-term complications of chemotherapy, whereas colitis/proctitis and cystitis were more frequent in the radiotherapy group (P = 0.000 respectively). No significant differences were found regards to other acute toxicities, including hemoglobin, platelets and ALT/AST, colitis/proctitis, cystitis and dermatitis (P = 0.000 respectively). Fewer late severe side effects in the chemotherapy group were observed compared with the radiation group and significant differences were found at colitis/proctitis, cystitis and dermatitis (P = 0.000 respectively).
  
  
  
  Compared to chemotherapy alone, postoperative RT to FIGO stages IB1 and IIA1 cervical carcinoma patients with isolated DSI can reduce risk of recurrence and with acceptable morbidity.
authors.affiliation: Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China. lilei04301596@163.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
authors.forename: XiaoYan
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: RuoNan
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: HongTu
authors.initials: H
authors.lastname: Chao
authors.affiliation: Department of Gynecologic Oncology, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, 450008, China.
authors.forename: LiYing
authors.initials: L
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000628:therapy*
chemical_list: D002945:Cisplatin
keywords: Cervical cancer; Chemotherapy; Deep stromal invasion (DSI); Radiotherapy