Department of Radiation Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Asian Pac J Cancer Prev. 2023 Apr 1;24(4):1321-1330. doi: 10.31557/APJCP.2023.24.4.1321.
The present study aimed at investigating the feasibility and safety of induction chemotherapy followed by definitive chemoradiation (dCRT) in patients with locally advanced cervical cancer.
In this single-arm clinical trial, patients with cervical cancer (stages IB3-IVA) received a median four cycles of induction chemotherapy (paclitaxel and carboplatin, every three weeks) followed by dCRT (which consisted of the whole pelvis at the dose of 45-50 Gy along with weekly cisplatin (40 mg/m2) followed by intracavitary brachytherapy at the total dose of 80-90 Gy). Primary end point was local control at three months, which was assessed by gynecologic examination and pelvic MRI. The secondary outcome of the study was treatment-related toxicity.
Seventy-four patients with the mean age of 51.6 ± 9.5 years were included. The most frequent (51.4%) disease stage was IIB. Complete and partial clinical responses were observed in 60.8% and 14.9% of patients, respectively. The frequency of progressive disease and stable disease were 14.9% and 9.5%, respectively. Grade II and III neutropenia (during neoadjuvant chemotherapy were 13.5% and 2.7%, respectively; these figures during chemoradiation were 29.7% and 13.5%, respectively. A treatment interruption was observed for 60.8% (45 cases) of patients during chemoradiation and 31.1% during induction chemotherapy.
Induction chemotherapy followed by chemoradiation is feasible in patients with locally advanced cervical cancer; however, the toxicity should be managed properly to avoid delayed e treatment. More than three quarters of the patients achieved complete or partial clinical response within a three-month follow-up.
本研究旨在探讨局部晚期宫颈癌患者接受诱导化疗后行根治性放化疗（dCRT）的可行性和安全性。
在这项单臂临床试验中，宫颈癌患者（IB3-IVA 期）接受了中位数为 4 个周期的诱导化疗（紫杉醇和顺铂，每 3 周 1 次），随后行 dCRT（全骨盆剂量为 45-50 Gy，同时每周给予顺铂 40mg/m2，随后腔内近距离放疗总剂量为 80-90 Gy）。主要终点为 3 个月时的局部控制，通过妇科检查和盆腔 MRI 评估。该研究的次要结局为治疗相关毒性。
共纳入 74 例年龄 51.6±9.5 岁的患者。最常见的（51.4%）疾病分期为 IIB 期。60.8%和 14.9%的患者分别观察到完全和部分临床缓解。疾病进展和稳定的频率分别为 14.9%和 9.5%。2 级和 3 级中性粒细胞减少（在新辅助化疗期间分别为 13.5%和 2.7%；在放化疗期间分别为 29.7%和 13.5%）。60.8%（45 例）的患者在放化疗期间和 31.1%的患者在诱导化疗期间需要中断治疗。
局部晚期宫颈癌患者接受诱导化疗后行放化疗是可行的；然而，应适当管理毒性，以避免延迟治疗。超过四分之三的患者在 3 个月的随访中达到完全或部分临床缓解。
