Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome

Objective. To assess the effectiveness and toxicity of carboplatin concurrent with pelvic external beam radiation and low-dose rate brachytherapy and to assess the impact that adherence to the treatment plan has on outcomes. Methods. Retrospective chart review of 56 patients treated from January 200...

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Main Authors: Juan Diaz, Daohai Yu, Bizhan Micaily, J. Stuart Ferriss, Enrique Hernandez
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Obstetrics and Gynecology International
Online Access:http://dx.doi.org/10.1155/2014/214351
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author Juan Diaz
Daohai Yu
Bizhan Micaily
J. Stuart Ferriss
Enrique Hernandez
author_facet Juan Diaz
Daohai Yu
Bizhan Micaily
J. Stuart Ferriss
Enrique Hernandez
author_sort Juan Diaz
collection DOAJ
description Objective. To assess the effectiveness and toxicity of carboplatin concurrent with pelvic external beam radiation and low-dose rate brachytherapy and to assess the impact that adherence to the treatment plan has on outcomes. Methods. Retrospective chart review of 56 patients treated from January 2001 to December 2010. Results. Median follow-up was 68 months. Optimal dose of radiation (ORT) was defined as a minimal cervical dose exceeding 70 Gy, point A dose of 80–90 Gy, and duration not exceeding 56 days. Only 50% received ORT. In multivariable analyses we only found ORT to be statistically significant predictor for progression-free survival (PFS) and overall survival (OS) (HR [95% CI] for non-ORT vs. ORT: 2.4 [1.2, 5.1], P=0.014 for PFS and 2.2 [1.1, 4.6], P=0.035 for OS). The 5-year PFS in patients who received ORT was better than that in patients who received non-ORT, 56% vs. 22% (95% CI: [36%, 72%] vs. [9%, 39%]). Patients who received ORT had a better 5-year OS as well (59% vs. 33%; 95% CI: [38%, 75%] vs. [16%, 51%]). Conclusion. Patients with locally advanced cervical cancer treated with weakly carboplatin or cisplatin, teletherapy, and low dose-dose rate brachytherapy have poorer outcomes when treatment duration is prolonged.
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spelling doaj-art-94fd0093a7214b38a54ed4f9b81866462025-02-03T05:46:34ZengWileyObstetrics and Gynecology International1687-95891687-95972014-01-01201410.1155/2014/214351214351Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on OutcomeJuan Diaz0Daohai Yu1Bizhan Micaily2J. Stuart Ferriss3Enrique Hernandez4Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Hospital, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA 19140, USADepartment of Clinical Sciences, Temple Clinical Research Center, Temple University Hospital, Temple University School of Medicine, Philadelphia, PA 19140, USADepartment of Radiation Oncology, Temple University Hospital, Temple University School of Medicine, Philadelphia, PA 19140, USADepartment of Obstetrics, Gynecology and Reproductive Sciences, Temple University Hospital, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA 19140, USADepartment of Obstetrics, Gynecology and Reproductive Sciences, Temple University Hospital, Temple University School of Medicine, 3401 N. Broad Street, Philadelphia, PA 19140, USAObjective. To assess the effectiveness and toxicity of carboplatin concurrent with pelvic external beam radiation and low-dose rate brachytherapy and to assess the impact that adherence to the treatment plan has on outcomes. Methods. Retrospective chart review of 56 patients treated from January 2001 to December 2010. Results. Median follow-up was 68 months. Optimal dose of radiation (ORT) was defined as a minimal cervical dose exceeding 70 Gy, point A dose of 80–90 Gy, and duration not exceeding 56 days. Only 50% received ORT. In multivariable analyses we only found ORT to be statistically significant predictor for progression-free survival (PFS) and overall survival (OS) (HR [95% CI] for non-ORT vs. ORT: 2.4 [1.2, 5.1], P=0.014 for PFS and 2.2 [1.1, 4.6], P=0.035 for OS). The 5-year PFS in patients who received ORT was better than that in patients who received non-ORT, 56% vs. 22% (95% CI: [36%, 72%] vs. [9%, 39%]). Patients who received ORT had a better 5-year OS as well (59% vs. 33%; 95% CI: [38%, 75%] vs. [16%, 51%]). Conclusion. Patients with locally advanced cervical cancer treated with weakly carboplatin or cisplatin, teletherapy, and low dose-dose rate brachytherapy have poorer outcomes when treatment duration is prolonged.http://dx.doi.org/10.1155/2014/214351
spellingShingle Juan Diaz
Daohai Yu
Bizhan Micaily
J. Stuart Ferriss
Enrique Hernandez
Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome
Obstetrics and Gynecology International
title Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome
title_full Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome
title_fullStr Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome
title_full_unstemmed Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome
title_short Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Cervical Carcinoma: Outcome Analysis with Emphasis on the Impact of Treatment Duration on Outcome
title_sort radiation therapy with concurrent chemotherapy for locally advanced cervical carcinoma outcome analysis with emphasis on the impact of treatment duration on outcome
url http://dx.doi.org/10.1155/2014/214351
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