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Published in: International Journal of Clinical Oncology 3/2015

01-06-2015 | Original Article

Effects of chemotherapy on patients with recurrent cervical cancer previously treated with concurrent chemoradiotherapy: a retrospective multicenter survey in Japan

Authors: Hideki Tokunaga, Toru Nakanishi, Takashi Iwata, Daisuke Aoki, Toshiaki Saito, Satoru Nagase, Fumiaki Takahashi, Nobuo Yaegashi, Yoh Watanabe

Published in: International Journal of Clinical Oncology | Issue 3/2015

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Abstract

Background

Predictive factors of the efficacy of chemotherapy for Japanese patients with recurrent cervical cancer who have been previously treated with concurrent chemoradiotherapy (CCRT) are currently unknown, and hence we aimed to investigate this.

Methods

We retrospectively studied the prognostic outcomes of patients with recurrent cervical cancer treated with CCRT between 2002 and 2010 at four medical facilities.

Results

A total of 64 patients were included in this study. Forty-two patients received definitive CCRT and 22 patients received postoperative adjuvant CCRT, with 55 receiving platinum-based combination chemotherapy and nine receiving single-agent chemotherapy. The overall response rate (ORR) was 12.5 %, with one complete response. The median survival period was 12 months. The ORR and overall survival rate did not differ significantly according to recurrence site, post-CCRT interval, or chemotherapy regimen.

Conclusion

None of the factors analyzed in this study were identified as positive predictive factors for the efficacy of chemotherapy in patients with recurrent cervical cancer after CCRT. Based on the results of previous studies, in order to improve long-term prognosis in recurrent cases, adjuvant chemotherapy should be considered as a potential treatment option for selected patients, especially as postoperative adjuvant therapy.
Literature
1.
go back to reference Peters WA 3rd, Liu PY, Barrett RJ et al (2000) 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. J Clin Oncol 18:1606–1613PubMed Peters WA 3rd, Liu PY, Barrett RJ et al (2000) 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. J Clin Oncol 18:1606–1613PubMed
2.
go back to reference Rose PG (2000) Chemoradiotherapy: the new standard care for invasive cervical cancer. Drugs 60:1239–1244PubMedCrossRef Rose PG (2000) Chemoradiotherapy: the new standard care for invasive cervical cancer. Drugs 60:1239–1244PubMedCrossRef
3.
go back to reference Morris M, Eifel PJ, Lu J et al (1999) Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med 340:1137–1143PubMedCrossRef Morris M, Eifel PJ, Lu J et al (1999) Pelvic radiation with concurrent chemotherapy compared with pelvic and para-aortic radiation for high-risk cervical cancer. N Engl J Med 340:1137–1143PubMedCrossRef
4.
go back to reference Rose PG, Bundy BN, Watkins EB et al (1999) Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 340:1144–1153PubMedCrossRef Rose PG, Bundy BN, Watkins EB et al (1999) Concurrent cisplatin-based radiotherapy and chemotherapy for locally advanced cervical cancer. N Engl J Med 340:1144–1153PubMedCrossRef
5.
go back to reference Whitney CW, Sause W, Bundy BN et al (1999) 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 17:1339–1348PubMed Whitney CW, Sause W, Bundy BN et al (1999) 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 17:1339–1348PubMed
6.
go back to reference Green JA, Kirwan JM, Tierney JF et al (2001) Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and meta-analysis. Lancet 358:781–786PubMedCrossRef Green JA, Kirwan JM, Tierney JF et al (2001) Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and meta-analysis. Lancet 358:781–786PubMedCrossRef
7.
go back to reference Lukka H, Hirte H, Fyles A et al (2002) Concurrent cisplatin-based chemotherapy plus radiotherapy for cervical cancer—a meta-analysis. Clin Oncol 14:203–212CrossRef Lukka H, Hirte H, Fyles A et al (2002) Concurrent cisplatin-based chemotherapy plus radiotherapy for cervical cancer—a meta-analysis. Clin Oncol 14:203–212CrossRef
9.
go back to reference Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247PubMedCrossRef Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247PubMedCrossRef
10.
go back to reference Omura GA, Blessing JA, Vaccarello L et al (1997) Randomized trial of cisplatin versus cisplatin plus mitolactol versus cisplatin plus ifosfamide in advanced squamous carcinoma of the cervix: a Gynecologic Oncology Group study. J Clin Oncol 15:165–171PubMed Omura GA, Blessing JA, Vaccarello L et al (1997) Randomized trial of cisplatin versus cisplatin plus mitolactol versus cisplatin plus ifosfamide in advanced squamous carcinoma of the cervix: a Gynecologic Oncology Group study. J Clin Oncol 15:165–171PubMed
11.
go back to reference Bloss JD, Blessing JA, Behrens BC et al (2002) Randomized trial of cisplatin and ifosfamide with or without bleomycin in squamous carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol 20:1832–1837PubMedCrossRef Bloss JD, Blessing JA, Behrens BC et al (2002) Randomized trial of cisplatin and ifosfamide with or without bleomycin in squamous carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol 20:1832–1837PubMedCrossRef
12.
go back to reference Moore DH, Blessing JA, McQuellon RP et al (2004) Phase III study of cisplatin with or without paclitaxel in stage IVB, recurrent, or persistent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol 22:3113–3119PubMedCrossRef Moore DH, Blessing JA, McQuellon RP et al (2004) Phase III study of cisplatin with or without paclitaxel in stage IVB, recurrent, or persistent squamous cell carcinoma of the cervix: a gynecologic oncology group study. J Clin Oncol 22:3113–3119PubMedCrossRef
13.
go back to reference Long HJ 3rd, Bundy BN, Grendys EC Jr et al (2005) Randomized phase III trial of cisplatin with or without topotecan in carcinoma of the uterine cervix: a Gynecologic Oncology Group Study. J Clin Oncol 23:4626–4633PubMedCrossRef Long HJ 3rd, Bundy BN, Grendys EC Jr et al (2005) Randomized phase III trial of cisplatin with or without topotecan in carcinoma of the uterine cervix: a Gynecologic Oncology Group Study. J Clin Oncol 23:4626–4633PubMedCrossRef
14.
go back to reference Teshima T, Inoue T, Ikeda H et al (1993) High-dose rate and low-dose rate intracavitary radiation therapy for cancer of the uterine cervix. Final results of Osaka University Hospital. Cancer 72:2409–2414PubMedCrossRef Teshima T, Inoue T, Ikeda H et al (1993) High-dose rate and low-dose rate intracavitary radiation therapy for cancer of the uterine cervix. Final results of Osaka University Hospital. Cancer 72:2409–2414PubMedCrossRef
15.
go back to reference Watanabe Y, Nakai H, Shimaoka M et al (2006) Feasibility of concurrent cisplatin use during primary and adjuvant chemoradiation therapy: a phase I study in Japanese patients with cancer of the uterine cervix. Int J Clin Oncol 11:309–313PubMedCrossRef Watanabe Y, Nakai H, Shimaoka M et al (2006) Feasibility of concurrent cisplatin use during primary and adjuvant chemoradiation therapy: a phase I study in Japanese patients with cancer of the uterine cervix. Int J Clin Oncol 11:309–313PubMedCrossRef
16.
go back to reference Ikushima H, Osaki K, Furutani S et al (2006) Chemoradiation therapy for cervical cancer: toxicity of concurrent weekly cisplatin. Radiat Med 24:115–121PubMedCrossRef Ikushima H, Osaki K, Furutani S et al (2006) Chemoradiation therapy for cervical cancer: toxicity of concurrent weekly cisplatin. Radiat Med 24:115–121PubMedCrossRef
17.
go back to reference Toita T, Kitagawa R, Hamano T et al (2012) Feasibility and acute toxicity of Concurrent Chemoradiotherapy (CCRT) with high-dose rate intracavitary brachytherapy (HDR-ICBT) and 40-mg/m2 weekly cisplatin for Japanese patients with cervical cancer: results of a Multi-Institutional Phase 2 Study (JGOG1066). Int J Gynecol Cancer 22:1420–1426PubMedCrossRef Toita T, Kitagawa R, Hamano T et al (2012) Feasibility and acute toxicity of Concurrent Chemoradiotherapy (CCRT) with high-dose rate intracavitary brachytherapy (HDR-ICBT) and 40-mg/m2 weekly cisplatin for Japanese patients with cervical cancer: results of a Multi-Institutional Phase 2 Study (JGOG1066). Int J Gynecol Cancer 22:1420–1426PubMedCrossRef
18.
go back to reference Monk BJ, Sill MW, McMeekin DS et al (2009) Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 27:4649–4655PubMedCentralPubMedCrossRef Monk BJ, Sill MW, McMeekin DS et al (2009) Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a Gynecologic Oncology Group study. J Clin Oncol 27:4649–4655PubMedCentralPubMedCrossRef
19.
go back to reference Moore DH, Tian C, Monk BJ et al (2010) Prognostic factors for response to cisplatin-based chemotherapy in advanced cervical carcinoma: a Gynecologic Oncology Group Study. Gynecol Oncol 116:44–49PubMedCrossRef Moore DH, Tian C, Monk BJ et al (2010) Prognostic factors for response to cisplatin-based chemotherapy in advanced cervical carcinoma: a Gynecologic Oncology Group Study. Gynecol Oncol 116:44–49PubMedCrossRef
20.
go back to reference Shimada M, Nishimura R, Hatae M et al (2013) Comparison of adjuvant chemotherapy and radiotherapy in patients with cervical adenocarcinoma of the uterus after radical hysterectomy: SGSG/TGCU Intergroup surveillance. Eur J Gynaecol Oncol 34:425–428PubMed Shimada M, Nishimura R, Hatae M et al (2013) Comparison of adjuvant chemotherapy and radiotherapy in patients with cervical adenocarcinoma of the uterus after radical hysterectomy: SGSG/TGCU Intergroup surveillance. Eur J Gynaecol Oncol 34:425–428PubMed
22.
go back to reference Lee TY, Jeung YJ, Lee CJ et al (2013) Promising treatment results of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage 1B cervical cancer. Obstet Gynecol Sci 56:15–21PubMedCentralPubMedCrossRef Lee TY, Jeung YJ, Lee CJ et al (2013) Promising treatment results of adjuvant chemotherapy following radical hysterectomy for intermediate risk stage 1B cervical cancer. Obstet Gynecol Sci 56:15–21PubMedCentralPubMedCrossRef
23.
go back to reference Takeshima N, Umayahara K, Fujiwara K et al (2006) Treatment results of adjuvant chemotherapy after radical hysterectomy for intermediate- and high-risk stage IB-IIA cervical cancer. Gynecol Oncol 103:618–622PubMedCrossRef Takeshima N, Umayahara K, Fujiwara K et al (2006) Treatment results of adjuvant chemotherapy after radical hysterectomy for intermediate- and high-risk stage IB-IIA cervical cancer. Gynecol Oncol 103:618–622PubMedCrossRef
24.
go back to reference Pignata S, Frezza P, Tramontana S et al (2000) Phase I study with weekly cisplatin-paclitaxel and concurrent radiotherapy in patients with carcinoma of the cervix uteri. Ann Oncol 11:455–459PubMedCrossRef Pignata S, Frezza P, Tramontana S et al (2000) Phase I study with weekly cisplatin-paclitaxel and concurrent radiotherapy in patients with carcinoma of the cervix uteri. Ann Oncol 11:455–459PubMedCrossRef
25.
go back to reference Rao GC, Rogers P, Drake RD et al (2005) Phase I clinical trial of weekly paclitaxel, weekly carboplatin, and concurrent radiotherapy for primary cervical cancer. Gyncol Oncol 96:168–172CrossRef Rao GC, Rogers P, Drake RD et al (2005) Phase I clinical trial of weekly paclitaxel, weekly carboplatin, and concurrent radiotherapy for primary cervical cancer. Gyncol Oncol 96:168–172CrossRef
26.
go back to reference Sehouli J, Runnebaum IB, Fotopoulou C et al (2012) A randomized phase III adjuvant study in high-risk cervical cancer: simultaneous radiochemotherapy with cisplatin (S-RC) versus systemic paclitaxel and carboplatin followed by percutaneous radiation (PC-R): a NOGGO-AGO Intergroup Study. Ann Oncol 23:2259–2264PubMedCrossRef Sehouli J, Runnebaum IB, Fotopoulou C et al (2012) A randomized phase III adjuvant study in high-risk cervical cancer: simultaneous radiochemotherapy with cisplatin (S-RC) versus systemic paclitaxel and carboplatin followed by percutaneous radiation (PC-R): a NOGGO-AGO Intergroup Study. Ann Oncol 23:2259–2264PubMedCrossRef
28.
go back to reference Schefter TE, Winter K, Kwon JS et al (2011) A phase II study of bevacizumab in combination with definitive radiotherapy and cisplatin chemotherapy in untreated patients with locally advanced cervical carcinoma: preliminary results of RTOG 0417. Int J Radiat Oncol Biol Phys 83:1179–1184CrossRef Schefter TE, Winter K, Kwon JS et al (2011) A phase II study of bevacizumab in combination with definitive radiotherapy and cisplatin chemotherapy in untreated patients with locally advanced cervical carcinoma: preliminary results of RTOG 0417. Int J Radiat Oncol Biol Phys 83:1179–1184CrossRef
Metadata
Title
Effects of chemotherapy on patients with recurrent cervical cancer previously treated with concurrent chemoradiotherapy: a retrospective multicenter survey in Japan
Authors
Hideki Tokunaga
Toru Nakanishi
Takashi Iwata
Daisuke Aoki
Toshiaki Saito
Satoru Nagase
Fumiaki Takahashi
Nobuo Yaegashi
Yoh Watanabe
Publication date
01-06-2015
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 3/2015
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-014-0728-9

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