Concurrent chemoradiation versus radiotherapy alone in cervical carcinoma: A randomized phase III trial

Aim Chemo‐radiotherapy (CRT) is the standard of care for treating almost all cervical carcinoma patients on the basis of the National Cancer Institute (NCI) alert. The disease burden in developing countries is more advanced with poor general condition than in patients in the trials prompting the NCI...

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Veröffentlicht in:Asia-Pacific journal of clinical oncology 2013-12, Vol.9 (4), p.349-356
Hauptverfasser: Srivastava, Kirti, Paul, Sayan, Chufal, Kundan Singh, Shamsundar, Sunkappa Dayashankara, Lal, Punita, Pant, Mohan C, Bhatt, Madanlal, Singh, Sudhir, Gupta, Rajeev
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container_end_page 356
container_issue 4
container_start_page 349
container_title Asia-Pacific journal of clinical oncology
container_volume 9
creator Srivastava, Kirti
Paul, Sayan
Chufal, Kundan Singh
Shamsundar, Sunkappa Dayashankara
Lal, Punita
Pant, Mohan C
Bhatt, Madanlal
Singh, Sudhir
Gupta, Rajeev
description Aim Chemo‐radiotherapy (CRT) is the standard of care for treating almost all cervical carcinoma patients on the basis of the National Cancer Institute (NCI) alert. The disease burden in developing countries is more advanced with poor general condition than in patients in the trials prompting the NCI alert. Therefore, practicing CRT as standard of care should be tested in these patients. Methods A randomized controlled trial was conducted comparing radiotherapy (RT) alone with CRT (cisplatin 40 mg/m2 weekly × 5) in patients with localized stage Ib to IVa cervical carcinoma between September 2006 and December 2008. External beam RT was delivered using a telecobalt unit. This was followed by 12–18 Gy of brachytherapy. Results In total, 305 patients were recruited: RT alone (150) and CRT (155). The median follow up was 34 months. Locoregional relapse‐free survival (LRFS) at 2 years was 55 and 54% for the RT and CRT group, respectively, with a median LRFS time of 27 and 30 months for the RT and CRT group, respectively, (P = 0.624). Overall survival (OS) at 2 years was 58 and 60%, with a median OS of 31 and 34 months for the RT and CRT group, respectively; (P = 0.9). The toxicity profile, both acute and late, were comparable in both groups; Conclusion No improvement in outcome was seen with addition of cisplatin. In the Indian subcontinent where patients present at late stages with poor general condition and limited access to good supportive care, RT alone still remains a valid option.
doi_str_mv 10.1111/ajco.12078
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The disease burden in developing countries is more advanced with poor general condition than in patients in the trials prompting the NCI alert. Therefore, practicing CRT as standard of care should be tested in these patients. Methods A randomized controlled trial was conducted comparing radiotherapy (RT) alone with CRT (cisplatin 40 mg/m2 weekly × 5) in patients with localized stage Ib to IVa cervical carcinoma between September 2006 and December 2008. External beam RT was delivered using a telecobalt unit. This was followed by 12–18 Gy of brachytherapy. Results In total, 305 patients were recruited: RT alone (150) and CRT (155). The median follow up was 34 months. Locoregional relapse‐free survival (LRFS) at 2 years was 55 and 54% for the RT and CRT group, respectively, with a median LRFS time of 27 and 30 months for the RT and CRT group, respectively, (P = 0.624). Overall survival (OS) at 2 years was 58 and 60%, with a median OS of 31 and 34 months for the RT and CRT group, respectively; (P = 0.9). The toxicity profile, both acute and late, were comparable in both groups; Conclusion No improvement in outcome was seen with addition of cisplatin. In the Indian subcontinent where patients present at late stages with poor general condition and limited access to good supportive care, RT alone still remains a valid option.</description><identifier>ISSN: 1743-7555</identifier><identifier>EISSN: 1743-7563</identifier><identifier>DOI: 10.1111/ajco.12078</identifier><identifier>PMID: 23710586</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Adult ; Antineoplastic Agents - therapeutic use ; Brachytherapy ; cancer ; cervix ; chemoradiation ; Chemoradiotherapy ; Cisplatin - therapeutic use ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; radiation ; Uterine Cervical Neoplasms - drug therapy ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - radiotherapy ; Young Adult</subject><ispartof>Asia-Pacific journal of clinical oncology, 2013-12, Vol.9 (4), p.349-356</ispartof><rights>2013 Wiley Publishing Asia Pty Ltd</rights><rights>2013 Wiley Publishing Asia Pty Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3678-9f5942317ec20fd6d057943aae1e4b649bea14eb568a43d163f291be538326663</citedby><cites>FETCH-LOGICAL-c3678-9f5942317ec20fd6d057943aae1e4b649bea14eb568a43d163f291be538326663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fajco.12078$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fajco.12078$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23710586$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Srivastava, Kirti</creatorcontrib><creatorcontrib>Paul, Sayan</creatorcontrib><creatorcontrib>Chufal, Kundan Singh</creatorcontrib><creatorcontrib>Shamsundar, Sunkappa Dayashankara</creatorcontrib><creatorcontrib>Lal, Punita</creatorcontrib><creatorcontrib>Pant, Mohan C</creatorcontrib><creatorcontrib>Bhatt, Madanlal</creatorcontrib><creatorcontrib>Singh, Sudhir</creatorcontrib><creatorcontrib>Gupta, Rajeev</creatorcontrib><title>Concurrent chemoradiation versus radiotherapy alone in cervical carcinoma: A randomized phase III trial</title><title>Asia-Pacific journal of clinical oncology</title><addtitle>Asia-Pac J Clin Oncol</addtitle><description>Aim Chemo‐radiotherapy (CRT) is the standard of care for treating almost all cervical carcinoma patients on the basis of the National Cancer Institute (NCI) alert. The disease burden in developing countries is more advanced with poor general condition than in patients in the trials prompting the NCI alert. Therefore, practicing CRT as standard of care should be tested in these patients. Methods A randomized controlled trial was conducted comparing radiotherapy (RT) alone with CRT (cisplatin 40 mg/m2 weekly × 5) in patients with localized stage Ib to IVa cervical carcinoma between September 2006 and December 2008. External beam RT was delivered using a telecobalt unit. This was followed by 12–18 Gy of brachytherapy. Results In total, 305 patients were recruited: RT alone (150) and CRT (155). The median follow up was 34 months. Locoregional relapse‐free survival (LRFS) at 2 years was 55 and 54% for the RT and CRT group, respectively, with a median LRFS time of 27 and 30 months for the RT and CRT group, respectively, (P = 0.624). Overall survival (OS) at 2 years was 58 and 60%, with a median OS of 31 and 34 months for the RT and CRT group, respectively; (P = 0.9). The toxicity profile, both acute and late, were comparable in both groups; Conclusion No improvement in outcome was seen with addition of cisplatin. In the Indian subcontinent where patients present at late stages with poor general condition and limited access to good supportive care, RT alone still remains a valid option.</description><subject>Adult</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Brachytherapy</subject><subject>cancer</subject><subject>cervix</subject><subject>chemoradiation</subject><subject>Chemoradiotherapy</subject><subject>Cisplatin - therapeutic use</subject><subject>Female</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>radiation</subject><subject>Uterine Cervical Neoplasms - drug therapy</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - radiotherapy</subject><subject>Young Adult</subject><issn>1743-7555</issn><issn>1743-7563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMofl_8AZKzUG2aJmm9LcWPlVVBFI9hmk7daNssSVddf71dV_foXGYYnnlhHkKOWHzKhjqDV-NOWRKrbIPsMpXySAnJN9ezEDtkL4TXOOZ5krNtspNwxWKRyV3yUrjOzL3Hrqdmiq3zUFnorevoO_owD3S5cP0UPcwWFBrXIbUdNejfrYGGGvDGdq6Fczoa2K5yrf3Cis6mEJCOx2PaewvNAdmqoQl4-Nv3ydPlxWNxHU3ur8bFaBIZLlUW5bXI04QzhSaJ60pWsVB5ygGQYVrKNC8RWIqlkBmkvGKS18NHJQqe8URKyffJySrXeBeCx1rPvG3BLzSL9dKWXtrSP7YG-HgFz-Zli9Ua_dMzAGwFfNgGF_9E6dFNcf8XGq1ubOjxc30D_k1LxZXQz3dXOr97KCbXt0o_8G9Td4Tz</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Srivastava, Kirti</creator><creator>Paul, Sayan</creator><creator>Chufal, Kundan Singh</creator><creator>Shamsundar, Sunkappa Dayashankara</creator><creator>Lal, Punita</creator><creator>Pant, Mohan C</creator><creator>Bhatt, Madanlal</creator><creator>Singh, Sudhir</creator><creator>Gupta, Rajeev</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>201312</creationdate><title>Concurrent chemoradiation versus radiotherapy alone in cervical carcinoma: A randomized phase III trial</title><author>Srivastava, Kirti ; 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Overall survival (OS) at 2 years was 58 and 60%, with a median OS of 31 and 34 months for the RT and CRT group, respectively; (P = 0.9). The toxicity profile, both acute and late, were comparable in both groups; Conclusion No improvement in outcome was seen with addition of cisplatin. In the Indian subcontinent where patients present at late stages with poor general condition and limited access to good supportive care, RT alone still remains a valid option.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>23710586</pmid><doi>10.1111/ajco.12078</doi><tpages>8</tpages></addata></record>
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subjects Adult
Antineoplastic Agents - therapeutic use
Brachytherapy
cancer
cervix
chemoradiation
Chemoradiotherapy
Cisplatin - therapeutic use
Female
Humans
Middle Aged
Neoplasm Staging
radiation
Uterine Cervical Neoplasms - drug therapy
Uterine Cervical Neoplasms - pathology
Uterine Cervical Neoplasms - radiotherapy
Young Adult
title Concurrent chemoradiation versus radiotherapy alone in cervical carcinoma: A randomized phase III trial
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