Multimodality approach in extra cervical locally advanced cervical cancer: Chemoradiation, surgery and intra-operative radiation therapy. A phase II trial

G. Giorda, G. Boz, A. Gadducci, E. Lucia, G. De Piero, A. De Paoli, R. Innocente, M. Trov, R. Sorio, E. Campagnutta

Research output: Contribution to journalArticle

Abstract

Background: The goal of this study was to determine the rational of radical surgery with intra-operative high-dose radiotherapy after chemoradiation (RT-CT) in extra cervical locally advanced cervical cancer (LACC) patients. Methods: Between 2000 and 2007, 42 LACC (stage IIA bulky-IVA) patients were treated at the Gynecologic Oncology Unit of the C.R.O. of Aviano in a Phase II Clinical Trial. Radiotherapy was administered to the whole pelvic region (50.4 Gy in 28 fractions) in combination with cisplatin (60 mg/mq) plus 5FU (750 mg/mq for 4 days) on first and fifth week of RT. Radical surgery with Intra-Operative Radiation Therapy (IORT) was performed 6-8 weeks after the end of RT-CT treatment. Results: After RT-CT, 35/42 patients (83%) underwent radical surgery and IORT treatment. At pathologic examination 8/35 (23%) patients showed complete response, while the rest (27/35) had residual disease either microscopic (17/27) or gross (10/27). The 5-year disease free survival (DFS) and the 5-year overall survival (OS) were 46% and 49% respectively. There were significant better DFS and OS when residual tumor was absent or limited to the cervix, respectively 78% versus 16% and 81% versus 20% (p <0.001). All recurrences occurred within 24 months from treatment. Conclusions: RT-CT followed by surgery and IORT in LACC patients seems to be active in a subgroup of patients with pathological complete response to treatment or partial response with residual tumor limited to the cervix.

Original languageEnglish
Pages (from-to)442-447
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume37
Issue number5
DOIs
Publication statusPublished - May 2011

Keywords

  • Chemotherapy
  • Combined modality therapy
  • Intra-operative radiotherapy
  • Locally advanced
  • Sugery
  • Uterine cervical neoplasms

ASJC Scopus subject areas

  • Oncology
  • Surgery

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