RT Journal Article
SR Electronic
T1 Chemoradiation with and without adjuvant extrafascial hysterectomy for IB2 cervical carcinoma
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 730
OP 735
DO 10.1136/ijgc-00009577-200807000-00018
VO 18
IS 4
A1 C. J. Darus
A1 M. B. Callahan
A1 Q.-N. Nguyen
A1 L. M. Pastore
A1 B. F. Schneider
A1 L. W. Rice
A1 A. A. Jazaeri
YR 2008
UL http://ijgc.bmj.com/content/18/4/730.abstract
AB The optimal treatment strategy for stage IB2 cervical carcinoma that maximizes survival while minimizing toxicity remains controversial. The purpose of this study was to compare survival and toxicity in stage IB2 cervical cancer patients treated with chemoradiation and adjuvant extrafascial hysterectomy (cRT + H) versus definitive chemoradiation (cRT). Data were abstracted from patients with IB2 cervical carcinoma primarily treated at a single institution from January 1994 to December 2004. All patients received chemotherapy concurrent with external beam radiation therapy. Patients were subsequently treated with either a single low–dose rate brachytherapy applicator followed by adjuvant extrafascial hysterectomy (n= 24) or a second brachytherapy application to complete full-dose definitive chemoradiation (n= 30). Analyses were conducted using Kaplan–Meier survival and Chi-square statistics. Groups did not differ demographically with the exception of smoking. Smokers were significantly (P= 0.04) more likely to have been treated with definitive chemoradiation. Median tumor size was similar between groups. There was no difference in overall or disease-free survival between patients who received cRT + H versus cRT (P= 0.82 and 0.75, respectively). All recurrences in the cRT arm were in smokers. There were two grade 3–4 toxicities in each group. No treatment-related deaths occurred. In this small retrospective cohort study, we observed no difference in survival between patients treated with cRT + H versus cRT. These data complement published results of Gynecologic Oncology Group studies in patients with IB2 cervical cancer. Definitive comparison between the two treatment strategies would require a randomized prospective trial with stratification based on smoking.