A randomized controlled trial comparing concurrent chemoradiation versus concurrent chemoradiation followed by adjuvant chemotherapy in locally advanced cervical cancer patients: ACTLACC trial.

Autor:	Tangjitgamol S; Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand. siriwanonco@yahoo.com., Tharavichitkul E; Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand., Tovanabutra C; Radiation Oncology Section, Chonburi Cancer Hospital, Chonburi, Thailand., Rongsriyam K; Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Asakij T; Radiation Oncology Section, Lampang Cancer Hospital, Lampang, Thailand., Paengchit K; Gynecologic Oncology section, Lampang Cancer Hospital, Lampang, Thailand., Sukhaboon J; Radiation Oncology Section, Lopburi Cancer Hospital, Lopburi, Thailand., Penpattanagul S; Radiation Oncology Section, Udonthani Cancer Hospital, Udon Thani, Thailand., Kridakara A; Radiation Oncology Section, Bhumibol Adulyadej Hospital, Bangkok, Thailand., Hanprasertpong J; Department of Obstetrics and Gynecology, Prince of Songkla University, Songkhla, Thailand., Chomprasert K; Radiation Oncology Section, Chonburi Cancer Hospital, Chonburi, Thailand., Wanglikitkoon S; Radiation Oncology Section, Udonthani Cancer Hospital, Udon Thani, Thailand., Atjimakul T; Department of Obstetrics and Gynecology, Prince of Songkla University, Songkhla, Thailand., Pariyawateekul P; Obstetrics and Gynecology Section, Bhumibol Adulyadej Hospital, Bangkok, Thailand., Katanyoo K; Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Tanprasert P; Obstetrics and Gynecology Section, Rajburi Hospital, Ratchaburi, Thailand., Janweerachai W; Radiation Oncology Section, Rajburi Hospital, Ratchaburi, Thailand., Sangthawan D; Department of Radiology, Prince of Songkla University, Songkhla, Thailand., Khunnarong J; Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Chottetanaprasith T; Radiation Oncology Section, Ubonratchathani Cancer Hospital, Ubon Ratchathani, Thailand., Supawattanabodee B; Department of Basic Sciences, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand., Lertsanguansinchai P; Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand., Srisomboon J; Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand., Isaranuwatchai W; Health Intervention and Technology Assessment Program, Nonthaburi, Thailand.; St. Michael's Hospital, University of Toronto, Toronto, Canada., Lorvidhaya V; Radiation Oncology Section, Chonburi Cancer Hospital, Chonburi, Thailand.
Jazyk:	angličtina
Zdroj:	Journal of gynecologic oncology [J Gynecol Oncol] 2019 Jul; Vol. 30 (4), pp. e82. Date of Electronic Publication: 2019 Apr 10.
DOI:	10.3802/jgo.2019.30.e82
Abstrakt:	Objective: To compare response rate and survivals of locally advanced stage cervical cancer patients who had standard concurrent chemoradiation therapy (CCRT) alone to those who had adjuvant chemotherapy (ACT) after CCRT. Methods: Patients aged 18-70 years who had International Federation of Gynecology and Obstetrics stage IIB-IVA without para-aortic lymph node enlargement, Eastern Cooperative Oncology Group scores 0-2, and non-aggressive histopathology were randomized to have CCRT with weekly cisplatin followed by observation (arm A) or by ACT with paclitaxel plus carboplatin every 4 weeks for 3 cycles (arm B). Results: Data analysis of 259 patients showed no significant difference in complete responses at 4 months after treatment between arm A (n=129) and arm B (n=130): 94.1% vs. 87.0% (p=0.154) respectively. With the median follow-up of 27.4 months, 15.5% of patients in arm A and 10.8% in arm B experienced recurrences (p=0.123). There were no significant differences of overall or loco-regional failure. However, systemic recurrences were significantly lower in arm B than arm A: 5.4% vs. 10.1% (p=0.029). The 3-year progression-free survival (PFS) and 3-year overall survival (OS) of the patients in both arms were not significantly different. The hazard ratio of PFS and OS of arm B compared to arm A were 1.26 (95% CI=0.82-1.96; p=0.293) and 1.42 (95% CI=0.81-2.49; p=0.221) respectively. Conclusions: ACT with paclitaxel plus carboplatin after CCRT did not improve response rate and survival compared to CCRT alone. Only significant decrease of systemic recurrences with ACT was observed, but not overall or loco-regional failure. Trial Registration: ClinicalTrials.gov Identifier: NCT02036164, Thai Clinical Trials Registry Identifier: TCTR 20140106001. Competing Interests: No potential conflict of interest relevant to this article was reported. (Copyright © 2019. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.)
Databáze:	MEDLINE
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