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Postoperative concurrent nedaplatin-based chemoradiotherapy improves survival in early-stage cervical cancer patients with adverse risk factors.

AbstractOBJECTIVES:
The aim of this study was to evaluate the efficacy of postoperative nedaplatin-based concurrent chemoradiotherapy (CCRT) in patients with FIGO stage IA2-IIB cervical cancer with adverse risk factors.
METHODS:
We retrospectively reviewed the medical records of 183 patients with early-stage cervical cancer who had undergone radical surgery between April 1997 and March 2006. Of these, 68 patients displayed high-risk prognostic factors such as positive pelvic lymph nodes, parametrial involvement, or a positive surgical margin. Fifty-seven patients demonstrated intermediate-risk prognostic factors including deep stromal invasion, capillary lymphatic space involvement, or large tumor diameter. These patients were treated postoperatively with CCRT or radiotherapy alone (RT). Fifty-eight patients showed no risk factors and, therefore, received no adjuvant therapy after surgery. The 3-year recurrence rate, progression free survival (PFS), and overall survival (OS) were compared between the treatment groups.
RESULTS:
CCRT was significantly superior to RT alone with regard to recurrence rate, PFS, and OS in patients that displayed high-risk and intermediate-risk prognostic factors. The frequencies of acute grade 3-4 toxicities were significantly higher in patients treated with CCRT than in those treated with RT alone. However, no statistically significant difference was observed with regard to severe late toxicities.
CONCLUSIONS:
Postoperative nedaplatin-based CCRT was safely performed and improved the prognosis of FIGO stage IA2-IIB cervical cancer patients displaying high-risk or intermediate-risk prognostic factors. This treatment can be considered as an alternative to cisplatin-based chemoradiotherapy in this patient population.
AuthorsSeiji Mabuchi, Ken-ichirou Morishige, Fumiaki Isohashi, Yasuo Yoshioka, Takashi Takeda, Toshiya Yamamoto, Kiyoshi Yoshino, Takayuki Enomoto, Takehiro Inoue, Tadashi Kimura
JournalGynecologic oncology (Gynecol Oncol) Vol. 115 Issue 3 Pg. 482-7 (Dec 2009) ISSN: 1095-6859 [Electronic] United States
PMID19783286 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antineoplastic Agents
  • Organoplatinum Compounds
  • nedaplatin
Topics
  • Adult
  • Antineoplastic Agents (adverse effects, therapeutic use)
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Staging
  • Organoplatinum Compounds (adverse effects, therapeutic use)
  • Prognosis
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Uterine Cervical Neoplasms (pathology, therapy)

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