Posttherapy residual disease associates with long-term survival after chemoradiation for bulky stage 1b>Bb> cervical carcinoma: a Gynecologic Oncology Group study

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• 作者：Charles Kunos ; Shamshad Ali ; Fadi W. Abdul-Karim ; Frederick B. Stehman ; Steven Waggoner
• 关键词：cervix cancer ; chemoradiation ; hysterectomy histopathology
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2010
• 出版时间：October 2010
• 年：2010
• 卷：203
• 期：4
• 页码：351.e1-351.e8
• 全文大小：616 K

文摘

Objective

The objective of the study was to study posttherapy chemoradiation hysterectomy histology with long-term survival in bulky stage 1b>Bb> cervical cancer patients.

Study Design

Gynecologic Oncology Group protocols 71 and 123 enrolled 464 patients randomly allocated to pelvic radiation (75 Gy, n = 291) plus hysterectomy (RTH) or to pelvic radiation (75 Gy) and cisplatin (40 mg/m², n = 176) plus hysterectomy (RTCH). Risk of progression and death were evaluated by posttherapy hysterectomy response (good: <10 % viable; poor: ≥10 % viable).

Results

Median survivor follow-up was 112 months. Relative risks of disease progression and death were 0.656 (95 % confidence interval, 0.472–0.912) and 0.638 (95 % confidence interval, 0.449–0.908), favoring RTCH. Good response patients (345; 74 % ) had similar 10 year overall survival (OS) and progression-free survival (PFS) after RTH or RTCH (P > .47). Poor response patients after RTCH had superior OS (P = .046) and PFS (P = .084). Extrapelvic recurrences occurred more often in poor response patients.

Conclusion

Posttherapy viable residual disease less than 10 % was associated with reduced risk of progression and cancer-related death.