How to Cite
Abstract
Purpose: to estimate the efficiency of the concurrent chemoradiotherapy (CRT) and radiotherapy (RT) alone for patients with the locally advanced cervical cancer (CC) taking into account prognostic factors.
Material and methods: The research included 335 patients with morphologically verified CC of the П-Ш stage on FIGO: 150 patients underwent RT (group 1): 185 patients - CRT with cisplatin and 5-fluorouracil (group 2). Patients in the group 1 were significantly older than patients of the group 2. The disease of the Stage III, parametric variant of the spread of the tumor, as well as metastatic lesions of the pelvic lymph nodes occurred more frequently in the group 2.
Results: In the group 1 complete response to treatment occurred in 98 cases (52.9%), while in the group 2 demonstrated - 64 (42.7%) patients (p < 0.01). Radioepithelitis of Grade 1 and 2 occurred more frequently in patients underwent CRT in this group haematologic and gastrointestinal toxicity was moderate and severe (p = 0.01). Study of late treatment outcomes with method Kaplan-Meyer demonstrated tendency to increase in indicators on the term of 5 years: the overall survival was 69.7±4.6% and 77.1±3.9 - in the group 1 and 2 respectively; the disease-free survival (DFS) was 69.5±4.5% and 75.1±4.1% - respectively; DFS at the II stage was 81.1±5.3% and 90.9±3.9% - respectively; at the III stage it was 56.4±7.3 and 66.1±5.6% respectively (p > 0.05). The variables that were found to be of independent significance for progression-free survival by multivariate analysis were stage of a disease, type of distribution and a morphological form of a tumor (p < 0.05); the method of treatment was not predictive in the probability of an adverse clinical outcome of locally advanced CC.
Conclusion: RT is an adequate method of treatment for a part of patients with II-III stages of CC of older patients with associated diseases, without reducing quality of life and also results of treatment.
References
Marth C., Landoni F, Mahner S., McCormack M., Gonzalez-Martin A., Colombo N. Cervical cancer: EsMo Clinical Practice Guidelines for diagnosis, treatment and follow-up // Annals of Oncology. 2017. Vol. 28. P. 72-83. URL: DOI: 10.1093/annonc/mdx220
Locally advanced cancer cervix: a systematic review and metaanalysis of 17 randomized trials to explore the therapeutic evidence for concurrent chemoradiotherapy over radiotherapy alone // European Journal of Cancer. 2017. Vol. 72. № 1. P S89. URL:10.1016/ S0959-8049(17)30374-X. DOI: 10.1016/S0959-8049
Dunst J., Haensgen G. Simultaneous radiochemotherapy in cervical cancer: recommendations for chemotherapy // Strahlenther Onkol. 2001. Vol. 177. № 12. P 635-40.
Rose P.G., Ali S., Watkins E., Thigpen J.T., Deppe G., Clarke-Pearson D.L., Insalaco S. Long-term follow-up of a randomized trial comparing concurrent single agent cisplatin, cisplatin-based combination chemotherapy, or hydroxyurea during pelvic irradiation for locally advanced cervical cancer // J. Clin. Oncol. 2007. Jul 1. № 25(19). P 2804-2810.
Eifel PJ. Nat Concurrent chemotherapy and radiation therapy as the standard of care for cervical cancer // Clin. Pract. Oncol. 2006. Vol. 3. № 5. P 248-255.
Meng X.Y, Liao Y, Liu X.P, Li S., Shi M.J., Zeng X.T. Concurrent cisplatin-based chemoradiotherapy versus exclusive radiotherapy in high-risk cervical cancer: a meta-analysis // Onco Targets Ther. 2016. Mar 31. № 9. P 1875-1888. DOI: 10.2147/OTT.S97436
Borowsky M.E., Elliott K.S., Pezzullo J.C., Santoso P, Choi W., Choi K., Abulafia O. A retrospective review of 15 years of radical radiotherapy with or without concurrent cisplatin and/or 5-fluorouracil for the treatment of locally advanced cervical cancer // Bull. Cancer. 2005. Feb. № 92(2). P E19-24.
URL: https://evs.nci.nih.gov/ftp1/CTCAE/About.html.
Eisenhauera E.A., Therasseb P, Bogaertsc J. et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) // European Journal of Cancer. 2009. Vol. 45. P 228-247.
Datta N.R., Stutz E., Michael Liu M. et al. Concurrent chemoradiotherapy vs. radiotherapy alone in locally advanced cervix cancer: A systematic review and metaanalysis. Gynecologic Oncology. 2017. Vol. 145. P 374385.
Mitra D., Ghosh B., Kar A., et al. Role of chemoradiotherapy in advanced carcinoma cervix, J. Indian Med. Assoc. 2006. Vol. 104. P 432-438.
F Bray, J. Ferlay, I. Soerjomataram, R. L. Siegel, L. A. Torre, A. Jemal. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries // CA Cancer. J. Clin. 2018. Vol. 68. P 394-424. URL: 10.3322/ caac.21492. DOI: 10.3322/caac.21492
Каприн А.Д., Старинский В.В., Петрова Г.В. Злокачественные новообразования в России в 2016 году (заболеваемость и смертность). М.: МНИОИ им. П.А. Герцена - филиал ФГБУ «НМИРЦ» Минздрава России; 2018. 250 с.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
© АННМО «Вопросы онкологии», Copyright (c) 2019