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01.07.2012 | Original article

Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

verfasst von: Dr. F. Heinzelmann, G. Henke, M. von Grafenstein, N. Weidner, F. Paulsen, A. Staebler, S. Brucker, M. Bamberg, M. Weinmann

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 7/2012

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Abstract

Background and purpose

The aim of this retrospective study was to analyze the outcome of patients with locally advanced cervical carcinoma treated by adjuvant radiochemotherapy and to determine risk factors for local and distant relapse. Furthermore, acute and late effects of treatment were recorded.

Patients and methods

A total of 72 patients with FIGO stages I–III cervical carcinoma were treated by radical hysterectomy, pelvic lymphadenectomy, and postoperative radiochemotherapy. Only patients with positive pelvic lymph nodes, parametrial involvement, positive margins, or tumor bulk were eligible. Patients were irradiated with a standard pelvic field (50.4 Gy in 28 fractions). The majority of patients received platinum-based chemotherapy.

Results

After a median follow-up of 37 months, estimated 1-, 2-, and 4-year disease-free survival (DFS) and overall survival (OS) rates were 89%, 80%, 68% and 95%, 88%, 76%, respectively. Nine of the 72 patients had pelvic recurrences including only 1 isolated local failure; 23 of the 72 patients presented with distant relapse. The majority of relapses occurred within the first 3 years after adjuvant treatment. The number of positive pelvic lymph nodes (> 1) was the strongest prognostic factor for DFS. Treatment was well tolerated with transient acute hematologic (~30%) and gastrointestinal (~30%) grade 3 toxicity. Small bowel obstruction (~6%) was the only important late sequelae.

Conclusion

Adjuvant radiochemotherapy in patients with advanced cervical cancer and several risk factors is highly effective to prevent local relapse. Future efforts to improve outcome should be placed on improvement of systemic control especially in subgroups with high-risk features for distant relapse. Combined treatment was well tolerated with moderate acute and late toxicity.

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Titel: Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer
verfasst von: Dr. F. Heinzelmann
G. Henke
M. von Grafenstein
N. Weidner
F. Paulsen
A. Staebler
S. Brucker
M. Bamberg
M. Weinmann
Publikationsdatum: 01.07.2012
Verlag: Springer-Verlag
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 7/2012
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-012-0123-2

Springer Medizin

Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer