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Cisplatin-Based Radiochemotherapy Improves the Negative Prognosis of c-erbB-2 Overexpressing Advanced Cervical Cancer
  1. José PÉRez-Regadera, MD*,
  2. Alfonso SÁNchez-MuÑOz, MD,
  3. Javier De-La-Cruz, MD,,
  4. Claudio BallestÍN, MD§,
  5. David Lora, MD,
  6. Rosa GarcÍA-MartÍN, MD§,
  7. Lorenzo Alonso-CarriÓN, MD,
  8. Cesar Mendiola, MD and
  9. Eduardo LanzÓS, MD*
  1. *Department of Radiation Oncology,
  2. Department of Medical Oncology,
  3. Department of Clinical Epidemiology, and
  4. §Department of Pathology, Hospital Universitario Doce de Octubre, Madrid, Spain;
  5. Department of Medical Oncology, Hospital Universitario de Jaén, Jaén, Spain; and
  6. Department of Medical Oncology, Hospital Virgen de la Victoria, Málaga, Spain.
  1. Address correspondence and reprint requests to José Pérez-Regadera, MD, PhD, Servicio de Oncología Radioterápica, Hospital Universitario Doce de Octubre, Avenida de Córdoba Km 5.4, 28041 Madrid, Spain. E-mail: asmoncomed{at}yahoo.es.

Abstract

Objectives: To determine the impact of c-erb-B2 overexpression on disease-free survival (DFS) and local relapse in patients with advanced cervical cancer (CC) receiving concurrent chemoradiotherapy treatment.

Methods: A total of 136 patients with advanced CC (FIGO stage: IB2-IIA [12]; IIB [34]; IIIB [71]; IVA [19]; including both epidermoid [86] and adenocarcinoma [14]) were analyzed to determine c-erb-B2 levels by immunohistochemistry (c-erb-B2 antibody; Dako, Glostrup, Denmark). Only c-erb-B2+++ biopsies were considered positive. All patients received pelvic radiotherapy, brachytherapy, and concurrent chemotherapy with 2 different regimens: 48 patients were treated with tegafur (800 mg/d orally) and 88 with tegafur (same doses) plus 5 cycles of weekly cisplatin 40 mg/m2/wk intravenously.

Results: A total of 32 (23.5%) biopsies were considered c-erb-B2-positive. Three-year and 5-year DFS were 61% and 58% for c-erb-B2-negative patients and 36% and 36% for c-erB2-positive patients, respectively (P = 0.02). Patients were stratified in 4 groups according to their c-erb-B2 status and whether they received cisplatin. The group of patients with c-erb-B2 overexpression that did not receive platinum treatment had a higher rate of pelvic relapse (P < 0.0001), associated with a decreased DFS (P = 0.0014).

Conclusions: c-erb-B2 overexpression may imply a poor prognosis for patients with advanced CC. Treatment with cisplatin-based radiochemotherapy improved outcome in these patients.

  • c-erb-B2 status
  • Disease-free survival
  • Local relapse rate
  • Advanced cervical cancer
  • Chemoradiotherapy

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Footnotes

  • Content: Cisplatin-based radiochemotherapy for c-erbB-2 + cervical cancer.

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