Pre-operative Concomitant Radio-chemotherapy in Bulky Carcinoma of the Cervix: A Single Institution Study

Autor: Anne De La Rochefordiere, Youlia Kirova, Severine Alran, Corine Plancher, Virginie Fourchotte, Philippe Beuzeboc, Vincent De Margerie, Peter Petrow, Xavier Sastre-Garau, Vincent Servois, Suzy Scholl, Paul Cottu, Laurent Mignot, Patricia De Cremoux, Remy Salmon
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Zdroj: Clinical Medicine Insights: Oncology, Vol 2 (2008)
Druh dokumentu: article
ISSN: 1179-5549
DOI: 10.4137/CMO.S489
Popis: Objective To evaluate the treatment results of patients (pts) with FIGO stage IB2, IIA, IIB cervical carcinoma (CC) treated with pre-operative radio-chemotherapy, followed by extended radical hysterectomy. Methods Retrospective study of 148 women treated to the Institut Curie for operable FIGO Stage IB2 to IIB, biopsy proved CC. Among them, 70 pts, median age 46 years, were treated using the same regimen associating primary radio-cisplatinum based chemotherapy, intracavitary LDR brachytherapy, followed by extended radical hysterectomy. Kaplan-Meier estimates were used to draw survival curves. Comparisons of survival distribution were assessed by the log-rank test. Results Complete histological local-regional response was obtained in 56% of the pts (n = 39). Residual macroscopic or microscopic disease in the cervix was observed in 28 pts (40%). All but one had in-situ microscopic residual CC. Lateral residual disease in the parametria was also present in 9 pts, all with residual CC. Pelvic lymph nodes were free from microscopic disease in 56 pts (80%). Eight of 55 (11%) radiological N0 patients had microscopic nodal involvement, as compared to 6/15 (40%) radiological N1 (p = 0.03). Seventeen pts (25%) had residual cervix disease but negative nodes. After median follow-up of 40 months (range, 8–141), 38/70 patients (54.1%) are still alive and free of disease, 6 (8.6%) alive with disease, and 11 (15.8%) patients were lost for follow-up but free of disease. In Conclusion The treatment of locally advanced CC needs a new multidisciplinary diagnostic and treatment approach using new therapeutic arms to improve the survival and treatment tolerance among women presenting this disease.
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