Details

Autor(en) / Beteiligte

• Nagy, Viorica
• Coza, Ovidiu
• Ordeanu, Claudia
• Třailă, Alexandru
• Rancea, Alin
• Todor, Nicolae
• Ghilezan, Nicolae

Titel

Radiotherapy versus Concurrent 5-Day Cisplatin and Radiotherapy in Locally Advanced Cervical Carcinoma: Long-Term Results of a Phase III Randomized Trial

Ist Teil von

• Strahlentherapie und Onkologie, 2009-03, Vol.185 (3), p.177-183

Ort / Verlag

Munchen: Urban and Vogel

Erscheinungsjahr

2009

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose: To prove the superiority of concurrent radiochemotherapy (RTCT) over radiotherapy (RT) alone in locally advanced cervical carcinoma. Patients and Methods: In this randomized monocentric phase III study, 566 patients with squamous cell carcinoma of the cervix were included: 284 in arm A (RT) and 282 in arm B (concurrent RTCT with cisplatin 20 mg/m 2 × 5 days). 238 patients (42%) were in stage IIB, 209 (37%) in stage IIIA, and 119 (21%) in stage IIIB. The median follow-up was 62.8 months. RT to the pelvis was delivered to a dose of 46 Gy/23 fractions. A cervical boost was given using the X-ray arch technique or high-dose-rate intracavitary brachytherapy at a dose of 10 Gy. Thereafter, patients were evaluated: those with good response optionally underwent surgery and the others continued RT until 64 Gy/pelvis (with or without CT according to randomization) and 14 Gy/central tumor volume. Results: The 5-year survival rate was statistically significantly superior in the concurrent RTCT group (74%) versus the RT group (64%; p < 0.05). In patients undergoing surgery after RT or RTCT, superior results were obtained, compared to the nonoperated patients: 5-year survival rate 86% versus 53% (p < 0.01). 192 failures were recorded: 109 (38%) after RT alone versus 83 (29%) after concurrent RTCT (p < 0.01). Conclusion: The results of this study prove the obvious superiority of concurrent RTCT with 5-day cisplatin compared to RT alone in patients with locally advanced cervical carcinoma, regarding local control (78% vs. 67%) and 5-year survival rates (74% vs. 64%).