Concomitant chemoradiation versus neoadjuvant chemotherapy in locally advanced cervical carcinoma: results from two consecutive phase II studies

Dueñas‐González, Alfonso; López-Graniel, C.; González-Enciso, Aarón; Mohar, Alejandro; Rivera, Lina María Saldarriaga; Mota, A.; Guadarrama, R.; Chanona, G.; Garza, Jaime de la

doi:10.1093/annonc/mdf196

Cited by 46 publications

(26 citation statements)

References 36 publications

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“…After this chemotherapy setting, maximum effort should be made to submit these patients for surgery, as the tumor cells remaining after induction chemotherapy will most likely be resistant to radiation. When the meta-analysis by Tierney et al [63] was planned, radiotherapy was the standard treatment, but in the meantime this has changed to concurrent chemoradiaton. Published data from two consecutive nonrandomized phase II trials suggest that neoadjuvant treatment can be effective as concurrent chemoradiation.…”

Section: Resultsmentioning

confidence: 99%

Neoadjuvant Chemotherapy: An Alternative Option of Treatment for Locally Advanced Cervical Cancer

Loizzi¹,

Cormio²,

Vicino³

et al. 2007

Gynecol Obstet Invest

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Although the incidence of cervical cancer has declined in both North America and Europe, it still represents the second most common cancer in women and the fifth most common malignancy worldwide. Most patients in the developed countries present with disease either confined to the cervix or with limited extension beyond it. Historically, the standard treatment was usually radiotherapy or radical hysterectomy with node dissection. In 1999, five randomized clinical trials performed by the Gynecologic Oncology Group, the Radiation Therapy Oncology Group and the Southwest Oncology Group have demonstrated a significant outcome advantage when cisplatin-based chemotherapy was administered during radiation in patients with cervical cancer. In the current review, we will analyze the role of neoadjuvant chemotherapy followed by radiotherapy and surgery as an alternative option treatment to the standard chemoradiation for locally advanced cervical cancer (stage Ib2 or larger).

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Section: Resultsmentioning

confidence: 99%

Neoadjuvant Chemotherapy: An Alternative Option of Treatment for Locally Advanced Cervical Cancer

Loizzi¹,

Cormio²,

Vicino³

et al. 2007

Gynecol Obstet Invest

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“…Their study design was essentially similar to ours. Duenas-Gonzalez et al [14] have also reported the effects of chemoradiation using cisplatin and gemcitabine in locally advanced cervical carcinomas, including adenocarcinomas stage IB2-IIIB. Their data showed that 33 out of 38 cases (87%) had a CR.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Preoperative Chemoradiation in Locally Advanced Cervical Carcinoma

Shibata

Kikkawa

Suzuki

et al. 2004

Gynecol Obstet Invest

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This study investigated response rate, toxicity, and influence on intra- and postoperative complications of neoadjuvant concurrent chemoradiation in locally advanced (Figo IB2–IIIB) cervical carcinomas. Twenty-eight patients (median age 46.5 years, age range 29–73 years), diagnosed as having squamous cell carcinomas (n = 21), adenocarcinomas (n = 6), and undifferentiated carcinoma (n = 1), entered this study. The chemoradiation protocol included external radiotherapy to the pelvis (39.6 Gy), intra-arterial or intravenous infusion of cisplatin (70 mg/m² on days 1 and 22), and 24-hour continuous intravenous infusion of 5-fluorouracil (700 mg/m² on days 1–4 and 22–25). Two weeks after the end of chemoradiotherapy, the patients underwent restaging followed by suitable operation including pelvic lymphadenectomy. The median follow-up period in the surviving patients was 13.1 months. The response rate for chemoradiation was 93% (26/28). The 2-year disease free survival was 85.2%. Grade 3–4 neutropenia was observed in 14 patients (50%), 4 patients (14%) showed grade 3 anemia, and 5 patients (17.8%) showed grade 3–4 thrombocytopenia. Nineteen patients (67.8%) could undergo surgery after concurrent chemoradiation. Pathological examination revealed a complete response (pT0) in 7 patients, and 5 patients showed only microscopic residual disease (pTmic). In 4 patients, there were intraoperative complications: vesical lesions in 2 (10%) and small intestine lesions in 2 (10%). Neoadjuvant therapy with concurrent chemoradiation for locally advanced cervical carcinoma is effective, safe, and useful for increasing operability rates as well as decreasing intra- and postoperative complications. Therefore, neoadjuvant concurrent chemoradiation should be considered for treatment in patients with locally advanced cervical carcinomas who could not undergo primary operation.

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“…In a separate trial, 41 patients were treated with standard cisplatin-based chemoradiation. At a median follow-up of 28 and 24 months, respectively, there were no signifi cant differences in PFS or OS in the NAC trial versus the standard chemoradiation trial indicating that either treatment modality may be acceptable [ 18 ]. In 2007, the Korean GOG reported a retrospective review of their experience using different treatment modalities for 692 stage IB2 cervical cancer patients treated between 1995 and 2005.…”

Section: Does Neoadjuvant Therapy Have a Place In The Management Of Cmentioning

confidence: 99%

What Is the Role of Cytotoxic Chemotherapy in Advanced Cervical Cancer?

Pant

Susumu

Toita

et al. 2013

Controversies in the Management of Gynecological Cancers

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Concomitant chemoradiation versus neoadjuvant chemotherapy in locally advanced cervical carcinoma: results from two consecutive phase II studies

Abstract: The results of this non-randomized comparison suggest that induction chemotherapy followed by surgery or chemoradiation is at least as effective in terms of response and survival as standard cisplatin-based chemoradiation. A randomized study is needed to confirm these findings.

Cited by 46 publications

References 36 publications

Neoadjuvant Chemotherapy: An Alternative Option of Treatment for Locally Advanced Cervical Cancer

Neoadjuvant Chemotherapy: An Alternative Option of Treatment for Locally Advanced Cervical Cancer

Usefulness of Preoperative Chemoradiation in Locally Advanced Cervical Carcinoma

What Is the Role of Cytotoxic Chemotherapy in Advanced Cervical Cancer?

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