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

01-07-2012 | Original article

Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer

Authors: Dr. F. Heinzelmann, G. Henke, M. von Grafenstein, N. Weidner, F. Paulsen, A. Staebler, S. Brucker, M. Bamberg, M. Weinmann

Published in: Strahlentherapie und Onkologie | Issue 7/2012

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Abstract

Background and purpose

The aim of this retrospective study was to analyze the outcome of patients with locally advanced cervical carcinoma treated by adjuvant radiochemotherapy and to determine risk factors for local and distant relapse. Furthermore, acute and late effects of treatment were recorded.

Patients and methods

A total of 72 patients with FIGO stages I–III cervical carcinoma were treated by radical hysterectomy, pelvic lymphadenectomy, and postoperative radiochemotherapy. Only patients with positive pelvic lymph nodes, parametrial involvement, positive margins, or tumor bulk were eligible. Patients were irradiated with a standard pelvic field (50.4 Gy in 28 fractions). The majority of patients received platinum-based chemotherapy.

Results

After a median follow-up of 37 months, estimated 1-, 2-, and 4-year disease-free survival (DFS) and overall survival (OS) rates were 89%, 80%, 68% and 95%, 88%, 76%, respectively. Nine of the 72 patients had pelvic recurrences including only 1 isolated local failure; 23 of the 72 patients presented with distant relapse. The majority of relapses occurred within the first 3 years after adjuvant treatment. The number of positive pelvic lymph nodes (> 1) was the strongest prognostic factor for DFS. Treatment was well tolerated with transient acute hematologic (~30%) and gastrointestinal (~30%) grade 3 toxicity. Small bowel obstruction (~6%) was the only important late sequelae.

Conclusion

Adjuvant radiochemotherapy in patients with advanced cervical cancer and several risk factors is highly effective to prevent local relapse. Future efforts to improve outcome should be placed on improvement of systemic control especially in subgroups with high-risk features for distant relapse. Combined treatment was well tolerated with moderate acute and late toxicity.
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Metadata
Title
Adjuvant radiochemotherapy in patients with locally advanced high-risk cervical cancer
Authors
Dr. F. Heinzelmann
G. Henke
M. von Grafenstein
N. Weidner
F. Paulsen
A. Staebler
S. Brucker
M. Bamberg
M. Weinmann
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/s00066-012-0123-2

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