PT - JOURNAL ARTICLE AU - Jonathan Teh AU - Swee Peng Yap AU - Ivan Tham AU - Vijay K. Sethi AU - Eu Jin Chua AU - Richard Yeo AU - Tew Hong Ho AU - Eng Hseon Tay AU - Yin Nin Chia AU - Lay Tin Soh AU - Hoon Seng Khoo-Tan TI - Concurrent Chemoradiotherapy Incorporating High-Dose Rate Brachytherapy for Locally Advanced Cervical Carcinoma: Survival Outcomes, Patterns of Failure, and Prognostic Factors AID - 10.1111/IGC.0b013e3181d4a0d1 DP - 2010 Apr 01 TA - International Journal of Gynecologic Cancer PG - 428-433--428-433 VI - 20 IP - 3 4099 - http://ijgc.bmj.com/content/20/3/428-433.short 4100 - http://ijgc.bmj.com/content/20/3/428-433.full SO - Int J Gynecol Cancer2010 Apr 01; 20 AB - Background: This is a retrospective study evaluating the survival outcomes, patterns of failure, and prognostic factors of chemoradiotherapy incorporating high-dose rate brachytherapy in the treatment of locally advanced cervical cancer.Methods: A review of 120 consecutive patients with Federation Internationale de Gynecologie et d'Obstetrique (FIGO) stages IB2 to IVA cervical cancer treated with concurrent cisplatin-based chemoradiotherapy between April 1999 and January 2005. Overall (OS) and disease-free survival (DFS) were analyzed using the Kaplan-Meier method.Results: The 5-year OS and DFS rates were, respectively, 65.0% (35.0% IB2, 65.7% IIA-B, 71.0% IIIA-B, and 40.0% IVA) and 57.3% (30.0% IB2, 58.2% IIA-B, 64.0% IIIA-B, and 40.0% IVA). Most patients had squamous cell carcinoma (89.2%) and belonged to FIGO stages IIB (40.8%) and IIIB (30.8%). All but 4 patients completed the planned radiotherapy regimen. There were 48 documented recurrences, of which 13 were locoregional only, 26 were distant only, and 9 were both sites. Five patients (4.2%) experienced late grade 3 to 4 gastrointestinal toxicity. On multivariate analysis, a preradiotherapy hemoglobin level of less than 10 g/dL and tumor size of 4 cm or greater or bulky on computed tomography were independently significant variables for OS, whereas a nadir hemoglobin level of less than 10 g/dL and presence of radiologically enlarged pelvic or paraaortic lymph nodes were independently significant variables for DFS.Conclusions: We conclude that this regimen is efficacious and feasible, but the safety profile about concurrent administration of high-dose rate brachytherapy and chemotherapy should be studied further. Finally, for cervical cancer patients selected for nonsurgical treatment, radiological assessment of tumor size and lymph node status can provide valuable prognostic information over and above FIGO staging alone.