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Reconsideration of postoperative concurrent chemoradiotherapy with fluorouracil and cisplatin for uterine cervical cancer
Author(s) -
Takekuma Munetaka,
Kasamatsu Yuka,
Kado Nobuhiro,
Kuji Shiho,
Tanaka Aki,
Takahashi Nobutaka,
Abe Masakazu,
Hirashima Yasuyuki
Publication year - 2015
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12754
Subject(s) - medicine , cervical cancer , neutropenia , chemoradiotherapy , surgery , fluorouracil , parametrium , oncology , gastroenterology , chemotherapy , cancer
Aim The aim of this retrospective study was to analyze data for patients with stage IB–IIB uterine cervical cancer who were treated with concurrent chemoradiotherapy with fluorouracil (5‐FU) and cisplatin (CCRT‐FP) as postoperative adjuvant therapy and to re‐examine these issues and further treatment. Methods Patients with high risk for recurrence underwent CCRT‐FP as postoperative adjuvant therapy. A total of 73 patients who met these criteria were included in this study. Data related to survival, toxicity, and treatment feasibility were analyzed, and the question of whether there were differences in survival and toxicity according to the number of dissected lymph nodes at surgery was evaluated. Results Median patient age was 45 years (range, 24–67 years). Two‐thirds of patients had squamous cell histologic type, 41 patients (56.2%) had parametrial invasion, and 60 patients (82.2%) had lymph node metastases. Estimated 4‐year progression‐free survival, overall survival, and local control rates were 71.8%, 84.1%, and 88.5%, respectively. Sixteen patients (21.9%) had grade 3–4 neutropenia and one of them died of septic shock. Non‐hematological toxicities were also common: 13 (17.8%) experienced grade 3–4 nausea, and nine (12.3%) experienced grade 3–4 diarrhea. Ileus occurred in 17 patients (23.3%), and seven of them (9.6%) were not yet cured. One patient experienced gastrointestinal perforation. Conclusions CCRT‐FP in the postoperative setting resulted in good survival outcome but toxicity remained problematic. Development of appropriate treatment for patients with high‐risk prognostic factors after radical hysterectomy and lymphadenectomy is required.