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First results of triple‐modality treatment combining radiotherapy, chemotherapy, and hyperthermia for the treatment of patients with Stage IIB, III, and IVA cervical carcinoma
Author(s) -
Westermann Anneke M.,
Jones Ellen L.,
Schem BaardChristian,
van der SteenBanasik Elzbieta M.,
Koper Peter,
Mella Olav,
Uitterhoeve Apollonia L. J.,
de Wit Ronald,
van der Velden Jacobus,
Burger Curt,
van der Wilt Clasina L.,
Dahl Olav,
Prosnitz Leonard R.,
van der Zee Jacoba
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21128
Subject(s) - medicine , radiation therapy , brachytherapy , chemoradiotherapy , chemotherapy , hyperthermia , cisplatin , external beam radiotherapy , carcinoma , cervical carcinoma , surgery , cervical cancer , oncology , cancer
BACKGROUND Patients with advanced cervical carcinoma are treated routinely with radiotherapy and cisplatin‐containing chemotherapy. It has been shown that hyperthermia can improve the results of both radiotherapy and cisplatin. In the current study, the feasibility and efficacy of the combination of all three modalities was studied in previously untreated patients with cervical carcinoma. METHODS Patients with advanced cervical carcinoma were registered prospectively in the U.S., Norway, and the Netherlands. External‐beam radiotherapy and brachytherapy were administered for a biologically effective dose ≥ 86.7 gray. At least 4 courses of weekly cisplatin (40 mg/m 2 ) and 4 sessions of weekly locoregional hyperthermia were added to radiotherapy. RESULTS Sixty‐eight patients with a median age of 45 years were enrolled. Full‐dose radiotherapy was delivered to all patients according to plan. At least 4 courses of chemotherapy were received by 97% of patients, and at least 4 courses of hyperthermia treatment were received by 93% of patients. Toxicity was fully comparable to that described for chemoradiotherapy alone, and the median total treatment time was 45 days. Complete remission was achieved by 61 patients (90%). After a median follow‐up of 538 days, 74% of patients remained alive without signs of recurrence, and the overall survival rate was 84%. CONCLUSIONS The combination of full‐dose radiotherapy, chemotherapy, and hyperthermia was feasible and effective in a multicenter international setting among patients with advanced cervical carcinoma. A Phase III study comparing this novel triplet with standard chemoradiation, designed to show at least a 15% improvement in overall survival, has been launched. Cancer 2005. © 2005 American Cancer Society.