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The effect of treatment time in locally advanced cervical cancer in the era of concurrent chemoradiotherapy
Cancer, 2013-01, Vol.119 (2), p.325-331
Song, Suisui
Rudra, Sonali
Hasselle, Michael D.
Dorn, Paige L.
Mell, Loren K.
Mundt, Arno J.
Yamada, S. Diane
Lee, Nita K.
Hasan, Yasmin
2013
Details
Autor(en) / Beteiligte
Song, Suisui
Rudra, Sonali
Hasselle, Michael D.
Dorn, Paige L.
Mell, Loren K.
Mundt, Arno J.
Yamada, S. Diane
Lee, Nita K.
Hasan, Yasmin
Titel
The effect of treatment time in locally advanced cervical cancer in the era of concurrent chemoradiotherapy
Ist Teil von
Cancer, 2013-01, Vol.119 (2), p.325-331
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2013
Link zum Volltext
Quelle
MEDLINE
Beschreibungen/Notizen
BACKGROUND: This study sought to determine if treatment time impacts pelvic failure (PF), distant failure (DF), or disease‐specific mortality (DSM) in patients undergoing concurrent chemoradiotherapy (CCRT). METHODS: A retrospective review was performed of 113 consecutive eligible patients with stage IB2 to IIIB cervical cancer. All patients received whole‐pelvis radiation with concurrent chemotherapy and consolidative intracavitary brachytherapy (BT) to the cervix, followed by an external beam parametrial boost when appropriate. The effect of treatment time on PF, DF, and DSM was examined with univariate and multivariate analyses. Characteristics of patients with and without treatment prolongation were compared to explore reasons for treatment prolongation. RESULTS: The median time to completion of BT was 60 days, and the median time to complete all RT was 68 days. The 3‐year cumulative incidence of PF, DF, and DSM were 18%, 23%, and 26%, respectively. On multivariate analysis, time to completion of BT >56 days was associated with increased PF (hazard ratio, 3.8; 95% confidence interval, 1.2‐16; P = .02). The 3‐year PF for >56 days versus ≤56 days was 26% versus 9% (P = .04). Treatment time was not associated with DF or DSM. Treatment prolongation was found to be associated with delay in starting BT and higher incidence of acute grade 3/4 toxicities. CONCLUSIONS: In the setting of CCRT, treatment time >56 days is detrimental to pelvic control but is not associated with an increase in DF or DSM. To maximize pelvic control, we recommend completing BT in 8 weeks or less. Cancer 2013. © 2012 American Cancer Society. The effect of treatment time has not been well studied for cervical cancer patients who were treated in the era of concurrent chemoradiotherapy. This multi‐institutional retrospective study found treatment time had a significant impact on pelvic failure, but not on distant failure or disease‐specific mortality. A prolonged treatment time was found to be associated with delay in starting brachytherapy and higher incidence of acute grade 3/4 toxicities.
Sprache
Englisch
Identifikatoren
ISSN: 0008-543X
eISSN: 1097-0142
DOI: 10.1002/cncr.27652
Titel-ID: cdi_crossref_primary_10_1002_cncr_27652
Format
–
Schlagworte
Adult
,
Aged
,
Aged, 80 and over
,
Biological and medical sciences
,
Brachytherapy
,
Carcinoma, Squamous Cell - mortality
,
Carcinoma, Squamous Cell - pathology
,
Carcinoma, Squamous Cell - therapy
,
cervical cancer
,
Chemoradiotherapy
,
concurrent chemoradiation
,
Disease-Free Survival
,
Female
,
Female genital diseases
,
Gynecology. Andrology. Obstetrics
,
Humans
,
Kaplan-Meier Estimate
,
Medical sciences
,
Middle Aged
,
Multivariate Analysis
,
Neoplasm Staging
,
prognostic factor
,
Radiation Dosage
,
radiation timing
,
Retrospective Studies
,
Time Factors
,
Treatment Outcome
,
treatment time
,
Tumors
,
Uterine Cervical Neoplasms - mortality
,
Uterine Cervical Neoplasms - pathology
,
Uterine Cervical Neoplasms - therapy
,
Young Adult
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