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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 7/2012

01-07-2012 | Original article

Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer

Toxicity, tumour response and outcome

Authors: K. Vandecasteele, M.D., A. Makar, M.D., Ph.D., R. Van den Broecke, M.D., Ph.D., L. Delrue, M.D., H. Denys, M.D., Ph.D., K. Lambein, M.D., B. Lambert, M.D., Ph.D., M. van Eijkeren, M.D., Ph.D., P. Tummers, M.D., G. De Meerleer, M.D., Ph.D.

Published in: Strahlentherapie und Onkologie | Issue 7/2012

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Abstract

Purpose

The goal of this work was to evaluate the feasibility and outcome of intensity-modulated arc therapy ± cisplatin (IMAT ± C) followed by hysterectomy for locally advanced cervical cancer.

Patients and methods

A total of 30 patients were included in the study. The primary tumour and PET-positive lymph node(s) received a simultaneous integrated boost. Four weeks after IMAT ± C treatment, response was evaluated. Resection consisted of hysterectomy with or without lymphadenectomy. Tumour response, acute and late radiation toxicity, postoperative morbidity and outcome were evaluated.

Results

All hysterectomy specimens were macroscopically tumour-free with negative resection margins; pathological complete response was 40%. In 2 patients, one resected lymph node was positive. There was no excess in postoperative morbidity. Apart from two grade 3 hematologic toxicities, no grade 3 or 4 acute radiation toxicity was observed. No grade 3, 1 grade 4 (4%) intestinal, and 4 grade 3 (14%) urinary late toxicities were observed. The 2-year local and regional control rates were 96% and 100%, respectively. The 2-year distant control rate was 92%. Actuarial 2-year progression free survival rate was 89%. Actuarial 1- and 2-year overall survival rates were 96% and 91%, while 3-year overall survival was 84%.

Conclusion

Surgery after IMAT ± C is feasible with low postoperative morbidity and radiation toxicity. Local, regional, distant control and survival rates are promising.
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Metadata
Title
Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer
Toxicity, tumour response and outcome
Authors
K. Vandecasteele, M.D.
A. Makar, M.D., Ph.D.
R. Van den Broecke, M.D., Ph.D.
L. Delrue, M.D.
H. Denys, M.D., Ph.D.
K. Lambein, M.D.
B. Lambert, M.D., Ph.D.
M. van Eijkeren, M.D., Ph.D.
P. Tummers, M.D.
G. De Meerleer, M.D., Ph.D.
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
Strahlentherapie und Onkologie / Issue 7/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-012-0097-0

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