Phase III, Open-Label, Randomized Study Comparing Concurrent Gemcitabine Plus Cisplatin and Radiation Followed by Adjuvant Gemcitabine and Cisplatin Versus Concurrent Cisplatin and Radiation in Patients With Stage IIB to IVA Carcinoma of the Cervix

Dueñas‐González, Alfonso; Zarbá, Juan José; Patel, Firuza D.; Alcedo, Juan Carlos; Beslija, S.; Casanova, Luís; Pattaranutaporn, Poompis; Hameed, Shahid; Blair, Julie; Barraclough, Helen; Orlando, Mauro

doi:10.1200/jco.2009.25.9663

Cited by 423 publications

(349 citation statements)

References 23 publications

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“…There were also more significantly hospitalization in the experimental group (30 versus 11 percent). Most of the excess toxicity occurred during chemoradiotherapy, the incidence of late toxicities in both groups were similar (Duenaz-Gonzalez et al, 2011).…”

Section: Discussionmentioning

confidence: 82%

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

Hashemi

Akbari²,

Kalaghchi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 82%

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

Hashemi

Akbari²,

Kalaghchi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Radiation therapy is an effective choice for advanced cervical cancer treatment, but radiotherapy effect itself is not satisfactory, therefore, the U.S. National Cancer Institute (NCI) in February 1999 announced to the world, that the combination of radiotherapy and chemotherapy treatment at the same time in advanced cervical cancer have good effect and suggested for patients who received radiotherapy, chemotherapy should be given the same time (Peters et al, 2000). Recent studies confirmed that concurrent radiotherapy and chemotherapy in advanced cervical cancer is safe and feasible, have good effect Dueñas-González et al, 2011). However, cervical cancer is not always sensitive to Chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Early Efficacy of Endostar Combined with Chemoradiotherapy for Advanced Cervical Cancers

Zhou²,

Huang³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Asian Pacific J Cancer Prev, 13, 923-926 IntroductionCervical cancer is the most common gynecologic cancer. Surgery or radiotherapy can achieve satisfactory effect for early stage cervical cancer, while in the late stage (II b-IV a period) the main treatment therapy is radiation. At present, many studies all over the world reported that radiotherapy combined with chemotherapy can improve the survival rate of patients with cervical cancer. Concurrent chemoradiation, using cisplatin-based chemotheraphy (either cisplatin alone or cisplatin/5-fluorouracil), is the treatment of choice for stages Ib-IV a disease based on the results of many randomized clinical trials. (Lu et al., 2003;Dubay et al., 2004;Eifel et al., 2004; Duenas-Gonzale et al., 2011). These trials have shown that the use of Concurrent chemoradiation results in a 30%-50% decrease in the risk of death compared to RT alone. Although the optimal Concurrent chemotheraphy regimen to use with RT requires further investigation, these trails clearly established a role for Concurrent cisplatin-based chemoradiation. However, cervical cancer is not always sensitive to Chemoradiotherapy. As one of the malignant tumor, the similar angiogenesis and lymphangiogenesis happen in cervical cancer, and the density of blood vessels and lymphatic vessels is related with the malignancy and biological characteristics of the tumor. Therefore, it sounds reasonable to suppress tumor development by way of suppressing angiogenesis and lymphangiogenesis. Jia et al. (2009) AbstractThe aim of this study was to investigate the early outcome of Endostar combined with chemoradiotherapy for advanced cervical cancer. Fifty-two cases (FIGO Ⅱb to Ⅳa) were divided randomly into two groups, receiving chemoradiotherapy alone (CRT group) and Endostar combined with chemoradiotherapy (CRT+E group). For the patients in the CRT+E group, Endostar was administered daily with the dosage of 7.5 mg/m 2 , and cisplatin was administered weekly with the dosage of 20 mg/m 2 during the radiation. The regimens lasted for 4 weeks with no difference in chemoradiotherapy between the two groups. The early outcome complete remission rate was 73.1%, partial remission rate was 23.1% and the total response rate was 96.2% in CRT+E group, a significnat improvement on the 34.6%, 42.3% and 76.9%, respectively, in the CRT group. One year survive rates were 100% and 84.6% in the CRT+E group and CRT groups, the difference being significant. Endostar combined with chemoradiotherapy can improve the early outcome of the advanced cervical cancer, and adverse effects were not encountered.

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“…For patients with locally advanced cervical cancer requiring treatment with concurrent chemoradiation (CCRT), approximately 30% develop new or persistent disease (PD) following treatment 2, 3. With recent studies showing significant improvements in progression‐free and overall survival with adjuvant chemotherapy albeit at a cost of grade 3 or greater toxicity approaching 90%,4 a capability for early identification of those cervical cancer patients at increased risk of new or PD would have potential to improve survival outcomes.…”

Section: Introductionmentioning

confidence: 99%

Pilot study of combined FDG‐PET and dynamic contrast‐enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response

et al. 2018

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Modern PET/CT radiotherapy simulators offer FDG‐PET and dynamic contrast‐enhanced (DCE) CT imaging for combined volumetric assessment of tumor metabolism and perfusion. However, the clinical utility of such assessment has not been clearly defined. Thus, in a prospective longitudinal study of primary cervical tumors treated with concurrent chemoradiotherapy (CCRT) we evaluated: (1) whether PET and perfusion parameters correlate or provide complementary information; (2) what imaging changes occur during CCRT; and (3) whether any parameters are predictive of treatment response as assessed by PET/CT 3 months posttherapy. FDG‐PET/CT and DCE‐CT scans were performed on 21 patients prior to and during CCRT. Coregistered volumetric parametric maps of standardized uptake value (SUV) measures and perfusion parameters blood flow (BF), blood volume (BV), and permeability were generated. Summary statistics for these parameters and their changes were calculated within the metabolic tumor volume (MTV). Correlations between SUV and BF/BV/permeability on local and global bases were assessed with Pearson's coefficient r. MTV, maximum SUV, and mean SUV decreased significantly between the pre‐ and during‐treatment time points, while mean BV and permeability increased significantly. Global correlations between mean BF/BV/permeability and mean SUV values (−.15 < r < .29) were at most moderate. An increase in mean tumor BV during treatment was significantly correlated with complete metabolic response on 3‐month posttreatment PET/CT. Weak correlations of SUV and perfusion parameters suggest a complementary role of FDG‐PET and DCE‐CT for tumor characterization. The association between relative change in mean BV and outcome suggests a potential role for DCE‐CT in early evaluation of cervical tumor response to chemoradiotherapy.

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Phase III, Open-Label, Randomized Study Comparing Concurrent Gemcitabine Plus Cisplatin and Radiation Followed by Adjuvant Gemcitabine and Cisplatin Versus Concurrent Cisplatin and Radiation in Patients With Stage IIB to IVA Carcinoma of the Cervix

Abstract: Gemcitabine plus cisplatin chemoradiotherapy followed by BCT and adjuvant gemcitabine/cisplatin chemotherapy improved survival outcomes with increased but clinically manageable toxicity when compared with standard treatment.

Cited by 423 publications

References 23 publications

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

Concurrent Chemoradiation with Weekly Gemcitabine and Cisplatin for Locally Advanced Cervical Cancer

Early Efficacy of Endostar Combined with Chemoradiotherapy for Advanced Cervical Cancers

Pilot study of combined FDG‐PET and dynamic contrast‐enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response

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