Therapy-free interval has prognostic value in patients with recurrent cervical cancer treated with chemotherapy following definitive concurrent chemoradiotherapy

Kozaki, Mitsuru; Sakuma, Saki; Kudaka, Wataru; Kinjyo, Yoshino; Taira, Yoichi; Arakaki, Yoshio; Shimoji, Yuko; Nakasone, Tadaharu; Nakamoto, Tomoko; Wakayama, Akihiko; Ooyama, Takuma; Aoki, Yoichi

doi:10.1007/s00404-017-4520-8

Cited by 10 publications

(18 citation statements)

References 20 publications

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“…The present study found that adverse events (thrombocytopenia, myelosuppression, hepatic or renal dysfunction) occurred more commonly in the radiochemotherapy group than in the DEB‐TACE group, suggesting DEB‐TACE has a comparative advantage in the context of safety profile . The incidence of complications, including postembolization syndrome, upper quadrant pain, fever, nausea, and vomiting, has also been reported to be much lower among HCC patients treated with DEB‐TACE than among those treated with conventional TACE .…”

Section: Discussionmentioning

confidence: 49%

Short‐term efficacy, safety, and cost‐effectiveness of transarterial chemoembolization with drug‐eluting beads versus synchronous radiochemotherapy for cervical cancer

Shen

Chen

Zhu

et al. 2019

Intl J Gynecology & Obste

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Objective To investigate the short‐term efficacy and safety of transarterial chemoembolization with drug‐eluting beads (DEB‐TACE) versus synchronous radiochemotherapy among women with cervical cancer. Methods A retrospective cohort study of women treated by synchronous radiochemotherapy (n=20) and DEB‐TACE (n=20) at a single center in China between November 2015 and September 2017. Inclusion criteria were pathologic diagnosis of cervical cancer, age at least 18 years, and complete clinicopathologic information. Hospital stay, direct medical cost, resection frequency, adverse events, treatment responses, progression‐free survival (PFS) and overall survival (OS) were compared between treatments. Results There was no difference in treatment responses, PFS, or OS between the two groups. Hospital stay was shorter, direct medical costs were lower, and resection rate was higher in the DEB‐TACE group than in the radiochemotherapy group (all P<0.05). In univariate and multivariate logistic regression analysis, no factor was associated with complete response. No predictive factor for PFS or OS was identified by Cox proportional regression analysis. Fewer adverse advents were recorded in the DEB‐TACE group than in the synchronous radiochemotherapy group. Conclusion Among women with cervical cancer, DEB‐TACE achieved equal short‐term efficacy, better tolerance, less hospital stay and medical costs, and higher resection rates as compared with synchronous radiochemotherapy.

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Section: Discussionmentioning

confidence: 49%

Short‐term efficacy, safety, and cost‐effectiveness of transarterial chemoembolization with drug‐eluting beads versus synchronous radiochemotherapy for cervical cancer

Shen

Chen

Zhu

et al. 2019

Intl J Gynecology & Obste

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“…However, patients eligible to receive third-line chemotherapy for recurrent cervical cancer can expect minimal benefits at the cost of significant toxicity (24). Other factors, such as the therapy-free interval, may influence the response to chemotherapy and the prognosis of recurrence after definitive CCRT (25).…”

Section: Discussionmentioning

confidence: 99%

Selection of Treatment Regimens for Recurrent Cervical Cancer

Chao

Song

et al. 2021

Front. Oncol.

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ObjectiveThe selection of individualized treatment for recurrent cervical cancer is challenging. This study aimed to investigate the impact of various therapies on survival outcomes after recurrence.MethodsEligible patients were diagnosed with recurrent cervical cancer between March 2012 and April 2018. Postrecurrence progression-free survival (PFS) and overall survival (OS) were investigated in the whole cohort and in subgroups, categorized by recurrence site and prior radiotherapy history, using a multivariate model that incorporated treatment for primary and recurrent tumors, histological pathology, and FIGO staging.ResultsTwo hundred and sixty recurrent cervical cancer patients were included. As of March 1, 2020, the median postrecurrence PFS and OS were 7.0 (range 0-94) and 24.0 (1.8-149.1) months, respectively. In a multivariate model measured by PFS, radiotherapy was superior to other therapies for the whole cohort (p=0.029) and recurrence only within the pelvic cavity (p=0.005), but the advantages of radiotherapy disappeared in patients with a history of radiotherapy (p values >0.05). For recurrence only beyond the pelvic cavity, combination therapy resulted in improved PFS (p=0.028). For recurrence both within and beyond the pelvic cavity, no therapy regimen provided additional PFS benefits (p values >0.05). Radiotherapy and combination therapy were also associated with improved postrecurrence OS for recurrence within the pelvic cavity (p=0.034) and only beyond the pelvic cavity (p=0.017), respectively.ConclusionsIn cervical cancer patients, postrecurrence radiotherapy can improve PFS and OS for patients with recurrence within the pelvic cavity and without prior radiotherapy. For recurrence beyond the pelvic cavity or cases with a history of radiotherapy, combination or individualized therapy may provide potential survival benefits.

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“…The curative effect of traditional radiotherapy and chemotherapy is poor, and complications are obvious. The tolerance and quality of life of patients are poor [9][10][11]. Immunotherapy is the main treatment for recurrent cervical cancer, but its clinical application is greatly limited due to its high price.…”

Section: Discussionmentioning

confidence: 99%

Radioactive 125I Seed Implantation for Recurrent Cervical Carcinoma After Surgery and Radiotherapy: A Case Report

Qiao

Zhang

et al. 2021

Preprint

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Background: The prognosis of cervical cancer is remarkable, but there are still instances of pelvic and/or extrapelvic recurrence after radical hysterectomy with platinum-based chemoradiotherapy. Sixty percent of the patients with radiotherapy (RT) failure have pelvic recurrence, and 80% of them relapse within two years after treatment. Recurrent cervical cancer seriously affects the prognosis and survival rate of patients. Due to the dose limitation for normal tissue, it is difficult to deliver a sufficient number of doses to recurrent lesions through reirradiation. With the rapid development of brachytherapy technologies such as three-dimensional afterloading brachytherapy, interstitial brachytherapy and radioactive 125I seed implantation, the overall survival (OS) of patients with recurrent cervical cancer has been improving. In the present study, a case in which the patient was successfully treated with radioactive 125I seed implantation is reported.Case presentation: The patient, a 47-year-old woman, was initially diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer and received preoperative radiotherapy, radical hysterectomy, pelvic lymph node dissection and postoperative radiotherapy. After 95 months of follow-up, retroperitoneal lymph node metastasis and edema of the left lower limb . The size of the retroperitoneal lesion was 2.3 × 2.0 cm, and the size of the left supraclavicle lesion was 2.0 × 1.5 cm. Radioactive 125I seed implantation was performed for retroperitoneal lymph node metastasis and left supraclavicular metastasis. Paclitaxel and cisplatin chemotherapy were given after the operation. Three months after implantation, the size of the retroperitoneal focus was 1.5 × 1.1 cm, and the size of the left supraclavicular lesion was 1.0 × 0.6 cm. Thirteen months after implantation, according to the RECIST standard, the therapeutic effect reached CR. At the time of submission, the patient's progression-free survival was 6 years and 4 months.Conclusions: CT-guided 125I seed implantation is a safe, effective, and minimally invasive method for treating patients with recurrent cervical cancer after radiotherapy. The response of this patient indicates that 125I seed implantation can be used as a complementary treatment for recurrent cervical cancer after chemoradiotherapy and may also prove to be reliable for comprehensive treatment of cervical cancer.

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Therapy-free interval has prognostic value in patients with recurrent cervical cancer treated with chemotherapy following definitive concurrent chemoradiotherapy

Abstract: TFI has predictive value for response to chemotherapy and prognosis of patients with recurrent cervical cancer after definitive CCRT.

Cited by 10 publications

References 20 publications

Short‐term efficacy, safety, and cost‐effectiveness of transarterial chemoembolization with drug‐eluting beads versus synchronous radiochemotherapy for cervical cancer

Short‐term efficacy, safety, and cost‐effectiveness of transarterial chemoembolization with drug‐eluting beads versus synchronous radiochemotherapy for cervical cancer

Selection of Treatment Regimens for Recurrent Cervical Cancer

Radioactive 125I Seed Implantation for Recurrent Cervical Carcinoma After Surgery and Radiotherapy: A Case Report

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