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Erschienen in: The Journal of Obstetrics and Gynecology of India 5/2016

01.05.2015 | Original Article

Induction Chemotherapy Followed by Concurrent Chemoradiation in the Management of Different Stages of Cervical Carcinoma: 5-year Retrospective Study

verfasst von: Kamlesh Kumar Harsh, Akhil Kapoor, Murali Paramanandhan, Satya Narayan, Ramesh Purohit, Pramila Kumari, Mukesh Kumar Singhal

Erschienen in: The Journal of Obstetrics and Gynecology of India | Ausgabe 5/2016

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Abstract

Aim

The data of survival for Indian cervical cancer patients treated by indigenous modifications of the protocol are scarce. The objective of this retrospective study was to analyze the efficacy and tolerability in patients of cervical carcinoma treated by neoadjuvant chemotherapy followed by concurrent chemoradiation.

Materials and Methods

Three hundred and thirty two cases of squamous cell carcinoma of cervix who received 3 cycles of neoadjuvant chemotherapy followed concurrent chemoradiation were retrospectively analyzed for overall survival (OS), disease-free survival (DFS), and local pelvic control rate.

Results

The 3-year OS and DFS were 93.7 % for stage I-B, 88.0 and 84.0 % for stage II-A, 82.8 and 79.7 % for stage II-B, 70.0 and 64.9 % for stage III-A, 59.3 and 52.4 % for stage III-B, and 53.6 and 32.1 % for stage IV-A disease. The 5-year OS and DFS rates were 93.7 and 87.5 % for stage I-B, 84.0 % for Stage II-A, 79.7 and 76.6 % for stage II-B, 67.6 and 59.5 % for stage III-A, 48.4 and 41.9 % for stage III-B, and 28.6 and 14.3 % for stage IV-A disease.

Conclusion

Neoadjuvant chemotherapy followed by concurrent chemoradiation is feasible and produces impressive disease-free and overall survival. This protocol is especially helpful for busy cancer centers with long waiting lists on radiotherapy machines.
Literatur
1.
Zurück zum Zitat Ferlay J, Soeryomataram I, Ervik M, et al. GLOBOCAN2012, Cancer incidence and mortality worldwide: IARC Cancer Base No. 11. Internet J Lyon France: International Agency for Research on Cancer; 2013. Ferlay J, Soeryomataram I, Ervik M, et al. GLOBOCAN2012, Cancer incidence and mortality worldwide: IARC Cancer Base No. 11. Internet J Lyon France: International Agency for Research on Cancer; 2013.
2.
Zurück zum Zitat Bray F, Ren JS, Masuyer E, et al. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013;132(5):1133–45.CrossRefPubMed Bray F, Ren JS, Masuyer E, et al. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013;132(5):1133–45.CrossRefPubMed
3.
Zurück zum Zitat Antonio GM, Lucia GC, Natalia C, et al. The Current role of neoadjuvant chemotherapy in the management of cervical carcinoma. Gynecol Oncol. 2008; 110(3 Suppl 2): S36–40. Antonio GM, Lucia GC, Natalia C, et al. The Current role of neoadjuvant chemotherapy in the management of cervical carcinoma. Gynecol Oncol. 2008; 110(3 Suppl 2): S36–40.
4.
Zurück zum Zitat Logsdon MD, Eifel PJ. Squamous cell carcinoma of the uterine cervix: an analysis of prognostic factors emphasizing the balance between external beam and intra-cavitary radiation therapy. Int J Radiat Oncol Biol Phys. 1999;43(4):763–75.CrossRefPubMed Logsdon MD, Eifel PJ. Squamous cell carcinoma of the uterine cervix: an analysis of prognostic factors emphasizing the balance between external beam and intra-cavitary radiation therapy. Int J Radiat Oncol Biol Phys. 1999;43(4):763–75.CrossRefPubMed
5.
Zurück zum Zitat Perez CA, Brady LW, Halperin EC, et al. Principles and practice of radiation oncology. 6th ed. Philadelphia: LWW; 2013. p. 1390–1. Perez CA, Brady LW, Halperin EC, et al. Principles and practice of radiation oncology. 6th ed. Philadelphia: LWW; 2013. p. 1390–1.
6.
Zurück zum Zitat Sardi J, Sananes C, Giaroli A, et al. Neoadjuvant chemotherapy in locally advanced carcinoma of the cervix uteri. Gynecol Oncol. 1990;38(3):486–93.CrossRefPubMed Sardi J, Sananes C, Giaroli A, et al. Neoadjuvant chemotherapy in locally advanced carcinoma of the cervix uteri. Gynecol Oncol. 1990;38(3):486–93.CrossRefPubMed
7.
Zurück zum Zitat Huang HJ, Chang TC, Hong JH, et al. Prognostic value of age and histologic type in neo-adjuvant chemotherapy plus radical surgery for bulky (≥4 cm) stage I-B and II-A cervical carcinoma. Int J Gynecol Cancer. 2003;13(2):204–11.CrossRefPubMed Huang HJ, Chang TC, Hong JH, et al. Prognostic value of age and histologic type in neo-adjuvant chemotherapy plus radical surgery for bulky (≥4 cm) stage I-B and II-A cervical carcinoma. Int J Gynecol Cancer. 2003;13(2):204–11.CrossRefPubMed
8.
Zurück zum Zitat Morris M, Eifel PJ, Lu J, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high risk cervical cancer. N Engl J Med. 1999;340(15):1137–43.CrossRefPubMed Morris M, Eifel PJ, Lu J, et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high risk cervical cancer. N Engl J Med. 1999;340(15):1137–43.CrossRefPubMed
9.
Zurück zum Zitat Symonds RP, Habeshaw T, Reed NS, et al. The Scottish and Manchester randomized trail of Neo-adjuvant chemotherapy for advanced cervical cancer. Eur J Cancer. 2000;36(8):994–1001.CrossRefPubMed Symonds RP, Habeshaw T, Reed NS, et al. The Scottish and Manchester randomized trail of Neo-adjuvant chemotherapy for advanced cervical cancer. Eur J Cancer. 2000;36(8):994–1001.CrossRefPubMed
10.
Zurück zum Zitat Napolitano U, Imperato F, Mossa B, et al. The role of neo-adjuvant chemotherapy for squamous cell cervical cancer (Ib-IIIb: a long term randomized trial. Eur J Gynaecol Oncol. 2003;24(1):51–9.PubMed Napolitano U, Imperato F, Mossa B, et al. The role of neo-adjuvant chemotherapy for squamous cell cervical cancer (Ib-IIIb: a long term randomized trial. Eur J Gynaecol Oncol. 2003;24(1):51–9.PubMed
11.
Zurück zum Zitat Thomas G, Dembo A, Fyles A, et al. Concurrent chemo-radiation in advanced cervical cancer. Gynaecol Oncol. 1990;38(3):446–51.CrossRef Thomas G, Dembo A, Fyles A, et al. Concurrent chemo-radiation in advanced cervical cancer. Gynaecol Oncol. 1990;38(3):446–51.CrossRef
12.
Zurück zum Zitat Chang TC, Lai CH, Hong JH, et al. Randomized trial of neoadjuvant cisplatin, vincristine, bleomycin, and radical hysterectomy versus radiation therapy for bulky stage IB and IIA cervical cancer. J Clin Oncol. 2000;18(8):1740–7.PubMed Chang TC, Lai CH, Hong JH, et al. Randomized trial of neoadjuvant cisplatin, vincristine, bleomycin, and radical hysterectomy versus radiation therapy for bulky stage IB and IIA cervical cancer. J Clin Oncol. 2000;18(8):1740–7.PubMed
13.
Zurück zum Zitat Rose PG, Bundy BN, Watkins EB, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340(15):1144–53.CrossRefPubMed Rose PG, Bundy BN, Watkins EB, et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med. 1999;340(15):1144–53.CrossRefPubMed
14.
Zurück zum Zitat Vale CL. Reducing uncertainties about the effects of chemo-radiotherapy for cervical cancer: individual patient data meta-analysis. Cochrane Gynaecol Cancer Group. 2013. doi:10.1002/14651858 Vale CL. Reducing uncertainties about the effects of chemo-radiotherapy for cervical cancer: individual patient data meta-analysis. Cochrane Gynaecol Cancer Group. 2013. doi:10.1002/14651858
15.
Zurück zum Zitat Nag S, Erickson B, Thomadsen B, et al. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cancer. Int J Radiat Oncol Biol Phys. 2000;48(1):201–11.CrossRefPubMed Nag S, Erickson B, Thomadsen B, et al. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cancer. Int J Radiat Oncol Biol Phys. 2000;48(1):201–11.CrossRefPubMed
16.
Zurück zum Zitat Hareyama M, Sakata K, Oouchi A, et al. High dose rate versus low dose rate intracavitary therapy for carcinoma of the uterine cervix: a randomized trial. Cancer. 2002;94(1):117–24.CrossRefPubMed Hareyama M, Sakata K, Oouchi A, et al. High dose rate versus low dose rate intracavitary therapy for carcinoma of the uterine cervix: a randomized trial. Cancer. 2002;94(1):117–24.CrossRefPubMed
17.
Zurück zum Zitat Nakano T, Kato S, Ohno T, et al. Long-term results of high- dose-rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix. Cancer. 2005;103(1):92–101.CrossRefPubMed Nakano T, Kato S, Ohno T, et al. Long-term results of high- dose-rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix. Cancer. 2005;103(1):92–101.CrossRefPubMed
18.
Zurück zum Zitat Perez CA, Grigsby PW, Lockett MA, et al. Radiation therapy morbidity in carcinoma of the uterine cervix: dosimetric and clinical correlation. Int J Radiat Oncol Biol Phys. 1999;44(4):855–66.CrossRefPubMed Perez CA, Grigsby PW, Lockett MA, et al. Radiation therapy morbidity in carcinoma of the uterine cervix: dosimetric and clinical correlation. Int J Radiat Oncol Biol Phys. 1999;44(4):855–66.CrossRefPubMed
Metadaten
Titel
Induction Chemotherapy Followed by Concurrent Chemoradiation in the Management of Different Stages of Cervical Carcinoma: 5-year Retrospective Study
verfasst von
Kamlesh Kumar Harsh
Akhil Kapoor
Murali Paramanandhan
Satya Narayan
Ramesh Purohit
Pramila Kumari
Mukesh Kumar Singhal
Publikationsdatum
01.05.2015
Verlag
Springer India
Erschienen in
The Journal of Obstetrics and Gynecology of India / Ausgabe 5/2016
Print ISSN: 0971-9202
Elektronische ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-015-0699-4

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