Concurrent chemotherapy and pelvic radiation therapy compared with pelvic radiation therapy alone as adjuvant therapy after radical surgery in high-risk early-stage cancer of the cervix
April 1, 2000
Does the addition of chemotherapy to RT after radical hysterectomy improve OS in women with early stage cervical cancer with high risk features (positive LN, margins or parametria)?
type 3 radical hysterectomypelvic lymphadenectomyEBRT 4930cGy
type 3 radical hysterectomypelvic lymphadenectomyEBRT 4930cGy1 cycle = cispaltin 70mg/m2 2hr infusion on day 1 of RT and 5FU 1000mg/m2 96hr continuous infusionthen cycles on day 22, 43, 64 (last 2 after RT complete)
type 3 radical hysterectomypelvic lymphadenectomystage IA2, IB or IIA cervical cancersquamous, adenocarcinoma, adenosquamouspositive LN, margin or parametria
RT only (n=116) vs chemo/RT (n=127): median f/u: 42 mosgrade 4 toxicity: n=4 vs n=274yr PFS: 63% vs 80% (SS)same pattern of recurrences4yr OS: 71% VS 81% (SS)worse prognosis of adeno and adenosquamous, mitigated by addition of chemotherapy
The addition of chemotherapy to RT after radical hysterectomy improves OS in women with early stage cervical cancer with high risk features (positive LN, margins or parametria)