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Intensity-modulated radiation therapy (IMRT)-based concurrent chemoradiotherapy (CCRT) with Endostar in patients with pelvic locoregional recurrence of cervical cancer: Results from a hospital in the Qinghai-Tibet Plateau.

Abstract
The treatment of recurrent cervical cancer, especially pelvic locoregional recurrence, is very challenging for gynecologic oncologists. This study investigated the efficacy and safety of intensity-modulated radiation therapy (IMRT)-based concurrent chemoradiotherapy (CCRT) with Endostar, a novel modified recombinant human endostatin, in patients with pelvic locoregional recurrence of cervical cancer following surgical treatment.This phase 2 study was conducted between May 2018 and May 2019 at a single center in the Qinghai-Tibet Plateau and enrolled 31 patients with pelvic locoregional recurrence of cervical cancer following surgical treatment. All patients were treated with IMRT-based CCRT for 6 weeks and intravenous infusions of Endostar (15 mg/m), which were administered on days 1 to 7 of CCRT, followed by rest for 4 weeks. After resting, chemotherapy with cisplatin (70 mg/m) plus paclitaxel (135-175 mg/m) was given every 3 weeks for a total of 4 treatments.Thirty-one patients were evaluable for the primary endpoint. The mean age was 50.03 years (SD 7.72). The objective response rate was 67.74% and the disease control rate was 83.87% (48.39% achieved a complete response, 19.35% a partial response, 16.13% had disease stabilization, and 16.13% had progressive disease). The most common adverse events were nausea, vomiting, alopecia, neutropenia, and leukopenia; most events were grade 1 or 2 in intensity. Grade 3 toxicities included thrombocytopenia and neutropenia in 2 patients each, and leukopenia in 4 patients. No cases of grade 4 acute toxicity were observed.IMRT-based CCRT with Endostar infusions is effective and safe. Our results support the use of this treatment for patients with pelvic locoregional recurrence of cervical cancer following surgical treatment.
AuthorsKuan Zhang, Huiping Wang, Zhenqing Wang, Fuqing Li, Ying Cui, Shengchun Ma, Rui Chen, Yuhui Wang, Shul Guo, Ying Wei
JournalMedicine (Medicine (Baltimore)) Vol. 99 Issue 49 Pg. e21966 (Dec 04 2020) ISSN: 1536-5964 [Electronic] United States
PMID33285664 (Publication Type: Clinical Trial, Phase III, Journal Article)
Chemical References
  • Endostatins
  • Recombinant Proteins
  • endostar protein
  • Paclitaxel
  • Cisplatin
Topics
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage, adverse effects, therapeutic use)
  • Chemoradiotherapy (methods)
  • Cisplatin (therapeutic use)
  • Endostatins (administration & dosage, adverse effects, therapeutic use)
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local (pathology)
  • Paclitaxel (therapeutic use)
  • Radiotherapy, Intensity-Modulated (methods)
  • Recombinant Proteins (administration & dosage, adverse effects, therapeutic use)
  • Tibet
  • Uterine Cervical Neoplasms (pathology, therapy)

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