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Effect of addition of bevacizumab to chemoradiotherapy in newly diagnosed stage IVB cervical cancer: a single institution experience in Korea
  1. Sang Hee Youn1,
  2. Yeon-Joo Kim1,
  3. Sang-Soo Seo2,
  4. Sokbom Kang2,
  5. Myong Cheol Lim2,
  6. Ha Kyun Chang2,
  7. Sang-Yoon Park2 and
  8. Joo-Young Kim1
  1. 1Proton Therapy Center, National Cancer Center, Goyang-si, Gyeonggi-do, the Republic of Korea
  2. 2Center for Uterine Cancer, National Cancer Center, Goyang-si, Gyeonggi-do, the Republic of Korea
  1. Correspondence to Dr Joo-Young Kim, Proton Therapy Center, National Cancer Center, Goyang-si 10408, the Republic of Korea; jooyoungcasa{at}


Objective The aim of this study was to compare the clinical outcomes of chemoradiotherapy with or without bevacizumab in patients with newly diagnosed International Federation of Gynecology and Obstetrics (FIGO) stage IVB cervical cancer.

Methods 41 patients with stage IVB cervical cancer who underwent chemoradiotherapy between August 2015 and December 2017 were retrospectively analyzed. This study included 11 patients who received bevacizumab before or after radiotherapy (group A) and 30 patients who received conventional chemoradiotherapy without bevacizumab (group B). We excluded the following patients: those with dual primary cancers; those whose pathologic diagnosis was neither squamous cell carcinoma nor adenocarcinoma; those who did not undergo radiotherapy; or those from whom follow-up data could not be collected. We analyzed the treatment responses, toxicities, progression-free survival, and overall survival rates.

Results A total of 41 patients were included in the analysis. The median follow-up was 19 months (range 3–108). The response rates at 3 months after treatment were 90.9% in group A and 83.3% in group B (p=0.54). After completing all treatments, the complete response rates were 81.8% in group A and 47% in group B (p=0.04). Grade ≥3 gastrointestinal toxicities, including bleeding, fistula, perforation, and obstruction, were more frequent in group A (54.5%) than in group B (6.7%) (p=0.003). The 12 month progression-free survival and overall survival rates were similar in both arms (12 month progression-free survival: 45.5% vs 46.7%, respectively, p=0.22; 12 month overall survival: 81.8% vs 72.9%, respectively, p=0.57). Patients with node-only metastasis had better 12 month progression-free survival in group B than in group A (59.1% vs 42.9%, respectively, p=0.04). However, the responses to both treatments did not differ in patients with organ metastasis.

Conclusions Bevacizumab for stage IVB cervical cancer is associated with higher complete response rates. However, patients treated with bevacizumab experienced more bowel toxicities. Bevacizumab did not improve progression-free survival among patients with node-only metastasis.

  • uterine cervical neoplasms
  • radiation oncology
  • radiotherapy

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  • Contributors Writing and final approval by all authors. Development of study and analysis by SHY and JK.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This retrospective study was approved by the Institutional Review Board of National Cancer Center in Korea (No. NCC2019-0246) and all methods were performed in accordance with the relevant guidelines and regulations. The requirement of informed consent was waived for this study, because of the retrospective nature of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement No data are available. The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials. Data sharing is not applicable to this article as no new data were created or analyzed in this study.