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The influence of overall treatment time to the efficiency of chemo-radiotherapy for locally advanced cervical cancer

Published online by Cambridge University Press:  19 June 2017

Ekkasit Tharavichitkul ,
Panupat Rugpong ,
Nisa Chawapun  and
Razvan M. Galalae
Ekkasit Tharavichitkul*
Affiliation:
Department of Radiology, The Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Panupat Rugpong
Affiliation:
Cancer Center, Khon kaen Hospital, Khon kaen, Thailand
Nisa Chawapun
Affiliation:
Department of Radiology, The Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Razvan M. Galalae
Affiliation:
Faculty of Medicine, Christian-Albrecht University, Kiel, Germany
*
Correspondence to: Ekkasit Tharavichitkul, Department of Radiology, The Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Tel: +66-053935356. Fax: +66 53 945491. E-mail: [email protected]
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Abstract

Purpose

This study aims to clarify the influence of overall treatment time (OTT) on the efficiency of combined chemo-radiotherapy in cervical cancer.

Material and methods

This retrospective study enrolled 122 cervical cancer patients who had squamous cell carcinoma and had undergone definitive chemo-radiotherapy from 2009 to 2013. All patients received whole pelvic radiotherapy (WPRT) with the dose of 50 Gy in 25 fractions (with central shielding after 44 Gy) plus intracavitary brachytherapy with the dose of 28 Gy in four fractions. During WPRT, all patients received concurrent chemotherapy with weekly platinum-based regimen. The data of patient characteristics, OTT, treatment results and toxicities were collected and evaluated.

Results

The mean follow-up time was 36 months. The mean age of patients was 52 years old; 68% of patients were stage IIB related to International Federation of Gynaecology and Obstetrics staging. Pelvic control (PC), distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates did not differ significantly in the data-derived cut points of 55·8 and 53 days. No statistically significant difference in treatment results between the two groups of OTT<49 and OTT≥62 days was observed.

Conclusions

In our data-derived cut point, OTT did not influence to PC, DMFS, DFS and OS. The influence of OTT on treatment results may be found in longer periods.

Keywords

cervical cancerchemotherapyinfluenceoverall treatment timeradiotherapy
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 17 , Issue 1 , March 2018 , pp. 124 - 130
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Copyright
© Cambridge University Press 2017 

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References

1. National Cancer Institute. Hospital-based cancer registry annual report 2012. Bangkok: Eastern Printing Public, 2014.Google Scholar
2. Fyles, A, Keane, T J, Barton, M, Simm, J. The effect of treatment duration in the local control of cervix cancer. Radiother Oncol 1992; 25: 273–279.CrossRefGoogle ScholarPubMed
3. Perez, C A, Grigsby, P W, Castro-Vita, H, Lockett, M A. Carcinoma of the uterine cervix. I. Impact of prolongation of overall treatment time and timing of brachytherapy on outcome of radiation therapy. Int J Radiat Oncol Biol Phys 1995; 32: 1275–1288.CrossRefGoogle ScholarPubMed
4. Petereit, D G, Sarkaria, J N, Chappell, R et al. The adverse effect of treatment prolongation in cervical carcinoma. Int J Radiat Oncol Biol Phys 1995; 32: 1301–1307.CrossRefGoogle ScholarPubMed
5. Chen, S W, Liang, J A, Yang, S N, Ko, H L, Lin, F J. The adverse effect of treatment prolongation in cervical cancer by high-dose-rate intracavitary brachytherapy. Radiother Oncol 2003; 67: 69–76.CrossRefGoogle ScholarPubMed
6. Ferrigno, R, Ribeito dos Santos Novaes, P E, Pellizzon, A C A et al. High-dose-rate brachytherapy in the treatment of uterine cervix cancer. Analysis of dose effectiveness and late complications. Int J Radiat Oncol Biol Phys 2001; 50: 1123–1135.CrossRefGoogle ScholarPubMed
7. Nag, S, Erickson, B, Thomadsen, B, Orton, C, Demanes, J D, Petereit, D. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 2000; 48: 201–211.CrossRefGoogle ScholarPubMed
8. Morris, M, Eifel, P J, Lu, J J et al. Pelvic radiation with concurrent chemotherapy compared with pelvic and paraaortic radiation for high-risk cervical cancer. N Engl J Med 1999; 340 (15): 1137–1143.CrossRefGoogle ScholarPubMed
9. Rose, P G, Bundy, B N, Watkins, E B et al. Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 1999; 340 (15): 1144–1153.CrossRefGoogle ScholarPubMed
10. Whitney, C W, Sause, W, Bundy, B N et al. Randomized comparison of fluorouracil plus cisplatin versus hydroxyurea as an adjunct to radiation therapy in stage IIB-IVA carcinoma of the cervix with negative para-aortic lymph nodes; a Gynecologic Oncology Group and Southwest Oncology Group study. J Clin Oncol 1999; 17 (5): 1339–1348.CrossRefGoogle ScholarPubMed
11. Pathy, S, Kumar, L, Pandey, R M et al. Impact of treatment time on chemoradiotherapy in locally advanced cervical carcinoma. Asian Pac J Cancer Prev 2015; 16: 5075–5079.CrossRefGoogle ScholarPubMed
12. Chandel, S S, Singh, K K, Nigam, A K, Baghel, R S. “The effect of treatment prolongation in treatment of cervical cancer patient”-treated patients at rural center in India. IOSR-JDMS 2013; 9: 70–75.CrossRefGoogle Scholar
13. Song, S, Rudra, S, Hasselle, M D et al. The effect of treatment time in locally advanced cervical cancer in the era of concurrent chemoradiotherapy. Cancer 2013; 119: 325–331.CrossRefGoogle ScholarPubMed
14. Amneus, M W, Park, S, Delit, L et al. Survival impact of prolonged treatment duration in primary chemoradiation for cervical cancer. Obstet Gynecol Int J 2015; 3 (3): 00081.Google Scholar
15. Pecorelli, S, Zigliani, L, Odicino, F. Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet 2009; 105: 107–108.CrossRefGoogle ScholarPubMed
16. International Commission on Radiation Units and Measurements (ICRU). Dose and volume specification for reporting intracavitary therapy in gynecology. ICRU report. Bethesda, MD: ICRU, 1985.Google Scholar
17. Miller, A B, Hoogstraten, B, Staquet, M, Winkler, A. Reporting results of cancer treatment. Cancer. 1981; 47: 207–214.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
18. Cox, J D, Stetz, J, Pajak, T F. Toxicity criteria of the radiation therapy oncology group (RTOG) and the European organization for research and treatment of cancer (EORTC). Int J Radiat Oncol Biol Phys 1995; 31: 1341–1346.CrossRefGoogle ScholarPubMed
19. Hong, J C, Foote, J, Broadwater, G et al. Total treatment duration for cervical cancer: is 55 days still the goal in the era of concurrent chemotherapy? Int J Radiat Oncol Biol Phys 2016; 96: S15.Google Scholar