Trattamento del carcinoma della cervice uterina stadio IIIB. Confronto tra radioterapia, chemio-radioterapia concomitante e chemioterapia neoadiuvante

Translated title of the contribution: Treatment of stage IIIB cervical carcinoma. A comparison between radiotherapy, concurrent chemo-radiotherapy and neoadjuvant chemotherapy

A. Maneo, A. Colombo, F. Landoni, A. Colombo, A. Villa, C. Mangioni

Research output: Contribution to journalArticle

Abstract

Aim. The aim of this study is to evaluate the effectiveness of radiation, concomitant chemoradiation and primary chemotherapy in the treatment of FIGO stage IIIB cervical carcinoma. Methods. Between January 1981 and December 2001 94 women with stage IIIB FIGO cervical carcinoma were observed. Exclusive radiotherapy was administered in 30 cases (32%), radiotherapy and radiosensitizing chemotheapy in 20 cases (21%) and primary chemotherapy in 44 cases (47%); among the latter patients 2 (4%) developed neoplastic progression, 28 (64%) underwent surgery and 14 (32%) underwent radiotherapy. Results. After a median follow-up of 69 months, 5-year overall survival of the 3 groups is respectively 23%, 36% and 26% (p=0.7). Total dose to point A greater than 60 Gy and the use of brachyradiotherapy are suggestive for a better outcome among women treated with radiation therapy (5-year overall survival 31% versus 18%, p=0.8 and 33% versus 23%, p=0.4, respectively). Radiologically assessed nodal status is the only statistically significant risk factor (p=0.001). Although not statistically significant, vaginal involvement is a relevant factor influencing survival (p=0.1). Women treated with concomitant chemoradiation showed a better 5-year disease-free survival (45%) when compared to the other treatment groups (radiation alone 27%, primary chemotherapy 30%, p=0.4). Conclusion. Primary chemotherapy, although useful to allow subsequent surgery, does not yield a survival advantage with respect to the irradiated patients. Among these, concomitant radiosensitizing chemotherapy is likely to improve the disease-free survival.

Original languageItalian
Pages (from-to)141-152
Number of pages12
JournalMinerva Ginecologica
Volume57
Issue number2
Publication statusPublished - 2005

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Radiotherapy
Carcinoma
Drug Therapy
Survival
Disease-Free Survival
Radiation
Therapeutics

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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Trattamento del carcinoma della cervice uterina stadio IIIB. Confronto tra radioterapia, chemio-radioterapia concomitante e chemioterapia neoadiuvante. / Maneo, A.; Colombo, A.; Landoni, F.; Colombo, A.; Villa, A.; Mangioni, C.

In: Minerva Ginecologica, Vol. 57, No. 2, 2005, p. 141-152.

Research output: Contribution to journalArticle

Maneo, A. ; Colombo, A. ; Landoni, F. ; Colombo, A. ; Villa, A. ; Mangioni, C. / Trattamento del carcinoma della cervice uterina stadio IIIB. Confronto tra radioterapia, chemio-radioterapia concomitante e chemioterapia neoadiuvante. In: Minerva Ginecologica. 2005 ; Vol. 57, No. 2. pp. 141-152.
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abstract = "Aim. The aim of this study is to evaluate the effectiveness of radiation, concomitant chemoradiation and primary chemotherapy in the treatment of FIGO stage IIIB cervical carcinoma. Methods. Between January 1981 and December 2001 94 women with stage IIIB FIGO cervical carcinoma were observed. Exclusive radiotherapy was administered in 30 cases (32{\%}), radiotherapy and radiosensitizing chemotheapy in 20 cases (21{\%}) and primary chemotherapy in 44 cases (47{\%}); among the latter patients 2 (4{\%}) developed neoplastic progression, 28 (64{\%}) underwent surgery and 14 (32{\%}) underwent radiotherapy. Results. After a median follow-up of 69 months, 5-year overall survival of the 3 groups is respectively 23{\%}, 36{\%} and 26{\%} (p=0.7). Total dose to point A greater than 60 Gy and the use of brachyradiotherapy are suggestive for a better outcome among women treated with radiation therapy (5-year overall survival 31{\%} versus 18{\%}, p=0.8 and 33{\%} versus 23{\%}, p=0.4, respectively). Radiologically assessed nodal status is the only statistically significant risk factor (p=0.001). Although not statistically significant, vaginal involvement is a relevant factor influencing survival (p=0.1). Women treated with concomitant chemoradiation showed a better 5-year disease-free survival (45{\%}) when compared to the other treatment groups (radiation alone 27{\%}, primary chemotherapy 30{\%}, p=0.4). Conclusion. Primary chemotherapy, although useful to allow subsequent surgery, does not yield a survival advantage with respect to the irradiated patients. Among these, concomitant radiosensitizing chemotherapy is likely to improve the disease-free survival.",
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AU - Landoni, F.

AU - Colombo, A.

AU - Villa, A.

AU - Mangioni, C.

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N2 - Aim. The aim of this study is to evaluate the effectiveness of radiation, concomitant chemoradiation and primary chemotherapy in the treatment of FIGO stage IIIB cervical carcinoma. Methods. Between January 1981 and December 2001 94 women with stage IIIB FIGO cervical carcinoma were observed. Exclusive radiotherapy was administered in 30 cases (32%), radiotherapy and radiosensitizing chemotheapy in 20 cases (21%) and primary chemotherapy in 44 cases (47%); among the latter patients 2 (4%) developed neoplastic progression, 28 (64%) underwent surgery and 14 (32%) underwent radiotherapy. Results. After a median follow-up of 69 months, 5-year overall survival of the 3 groups is respectively 23%, 36% and 26% (p=0.7). Total dose to point A greater than 60 Gy and the use of brachyradiotherapy are suggestive for a better outcome among women treated with radiation therapy (5-year overall survival 31% versus 18%, p=0.8 and 33% versus 23%, p=0.4, respectively). Radiologically assessed nodal status is the only statistically significant risk factor (p=0.001). Although not statistically significant, vaginal involvement is a relevant factor influencing survival (p=0.1). Women treated with concomitant chemoradiation showed a better 5-year disease-free survival (45%) when compared to the other treatment groups (radiation alone 27%, primary chemotherapy 30%, p=0.4). Conclusion. Primary chemotherapy, although useful to allow subsequent surgery, does not yield a survival advantage with respect to the irradiated patients. Among these, concomitant radiosensitizing chemotherapy is likely to improve the disease-free survival.

AB - Aim. The aim of this study is to evaluate the effectiveness of radiation, concomitant chemoradiation and primary chemotherapy in the treatment of FIGO stage IIIB cervical carcinoma. Methods. Between January 1981 and December 2001 94 women with stage IIIB FIGO cervical carcinoma were observed. Exclusive radiotherapy was administered in 30 cases (32%), radiotherapy and radiosensitizing chemotheapy in 20 cases (21%) and primary chemotherapy in 44 cases (47%); among the latter patients 2 (4%) developed neoplastic progression, 28 (64%) underwent surgery and 14 (32%) underwent radiotherapy. Results. After a median follow-up of 69 months, 5-year overall survival of the 3 groups is respectively 23%, 36% and 26% (p=0.7). Total dose to point A greater than 60 Gy and the use of brachyradiotherapy are suggestive for a better outcome among women treated with radiation therapy (5-year overall survival 31% versus 18%, p=0.8 and 33% versus 23%, p=0.4, respectively). Radiologically assessed nodal status is the only statistically significant risk factor (p=0.001). Although not statistically significant, vaginal involvement is a relevant factor influencing survival (p=0.1). Women treated with concomitant chemoradiation showed a better 5-year disease-free survival (45%) when compared to the other treatment groups (radiation alone 27%, primary chemotherapy 30%, p=0.4). Conclusion. Primary chemotherapy, although useful to allow subsequent surgery, does not yield a survival advantage with respect to the irradiated patients. Among these, concomitant radiosensitizing chemotherapy is likely to improve the disease-free survival.

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