title: Postoperative adjuvant chemotherapy combined with intracavitary brachytherapy in early-stage cervical cancer patients with intermediate risk factors.
abstract: OBJECTIVE
  To investigate the impact of postoperative adjuvant therapy on survival of patients with intermediate risk early-stage cervical squamous cell carcinoma.
  
  
  METHODS
  A total of 133 consecutive patients with intermediate risk early-stage cervical squamous cell carcinoma treated at Shandong Cancer Hospital and Institute from February 2010 to March 2014 were enrolled in our study. All patients received adjuvant therapy and were subdivided into three groups: pelvic radiotherapy (RT; N=42), adjuvant chemotherapy + intracavitary radiotherapy (CT+ICRT; N=47), or concurrent chemoradiation (CCRT; N=44). Disease-free survival (DFS) and therapeutic complications were evaluated.
  
  
  RESULTS
  There were no significant differences in DFS for patients treated with RT, CT+ICRT, and CCRT (P>0.05) with 3-year rates of 94.0%, 93.4%, and 97.6%, respectively. Frequencies of grade III-IV acute toxicities were higher in patients treated with CCRT (34.1%) than those treated with RT (9.5%) or CT+ICRT (16.7%;P<0.05), with no significant differences observed between RT and CT+ICRT groups (P>0.05). Grade I-II late toxicities were higher in CCRT (25%), followed by RT (19.0%), and finally, the CT+ICRT group (4.3%;P<0.05); with no significant differences observed between CCRT and RT groups (P>0.05).
  
  
  CONCLUSIONS
  Treatment with CT+ICRT or RT resulted in the equivalent of 3-year DFS compared to CCRT, but fewer therapeutic complications were observed with CT for patients with intermediate risk early-stage cervical squamous cell carcinoma.
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University.
authors.forename: Hao
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Obstetrics and Gynecology, Jinan Fourth People's Hospital, Jinan, People's Republic of China.
authors.forename: Linlin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University.
authors.forename: Xuelian
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Gynecologic Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong University.
authors.forename: Xiugui
authors.initials: X
authors.lastname: Sheng
keywords: cervical squamous cell carcinoma; chemotherapy; concurrent chemoradiotherapy; radiotherapy