Genitourinary Cancer

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TU_13_3447 - Neoadjuvant Chemotherapy Followed By Surgery/Chemoradiotherapy Versus Radical Chemoradiotherapy in Locally Advanced Cervical Carcinoma: A Retrospective Multicenter Study of 388 Patients

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Neoadjuvant Chemotherapy Followed By Surgery/Chemoradiotherapy Versus Radical Chemoradiotherapy in Locally Advanced Cervical Carcinoma: A Retrospective Multicenter Study of 388 Patients
G. Cheng1, M. He2, X. Su3, H. Song4, Y. Li5, F. Gu6, X. Sun7, and X. Li3; 1China-Japan Union Hospital of Jilin University, Changchun, China, 2Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China, 3Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China, 4Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, China, 5Department of Radiation Oncology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China, 6Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, Shenyang, China, 7Department of Radiation Oncology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China

Purpose/Objective(s): The purpose of the present study was to compare the oncologic outcomes and side effect between neoadjuvant chemotherapy followed by surgery/chemoradiotherapy versus radical chemoradiotherapy for locally advanced cervical carcinoma.

Materials/Methods: We conducted a retrospective review of patients who suffered from locally advanced cervical carcinoma (International Federation of Gynecology and Obstetrics (FIGO) stage IB2, IIA2 and IIB) at six hospitals between June 2007 and January 2017. The oncologic outcomes and side effect between the neoadjuvant chemotherapy followed by radical hysterectomy /chemoradiotherapy and radical chemoradiotherapy were compared.

Results: A total of 388 patients were studied. The median (range) age was 51.0±9.6 years old. The distribution of patients by FIGO stage was as follows: 35 (9 %) with stage IB2, 27 (12.1 %) with stage IIA2 and 306 (78.9 %) with stage IIB. The histopathology included squamous carcinoma (86.6 %), adenocarcinoma (4.1 %) and others (9.3 %). 278 patients received radical chemoradiotherapy with cisplatin based external beam radiotherapy plus high-dose-rate brachytherapy (Standard Group). Neoadjuvant chemotherapy involved a combination of 3-4 cycles cisplatin plus paclitaxel regimen in 110 patients. Complete and partial pathology response were observed in 9 patients (7 %) and 79 patients (72 %), respectively. Using this treatment, 65 patients (59 %) received radical hysterectomy and adjuvant radiotherapy (Surgery group), whereas 45 patients (41 %) received chemoradiotherapy (Neo-Ra Group). The 5-year overall survival (OS) was observed with 92.5 % for Surgery Group, and 84.9 % for Standard Group, which was not significant, but both groups were higher than that 75.6 % for Neo-Ra Group (p < 0.005). The 5-year disease free survival (DFS) and progress free survival (PFS) were 89.2 % and 87.7 % in Surgery Group, 77.8 % and 77.8 % in Neo-Ra Group, and 81.7 % and 80.9 % in Standard Group, respectively, which was not significant among any groups. The Radiation Therapy Oncology Group (RTOG) grade 1-3 gastrointestinal toxicity were seen in 23 % cases for Surgery Group, 18 % cases for Neo-Ra Group, and 26 % cases for Standard Group, respectively, which was not significant. And the RTOG grade 1-3 genitourinary toxicity were seen in 11 % cases for Surgery Group, 4 % cases for Neo-Ra Group, and 16 % cases for Standard Group, respectively, which was not significant either. No patient had grade 4 adverse effect.

Conclusion: Our results show neoadjuvant chemotherapy followed by radical hysterectomy is a feasible and reliable therapy concept, which results in encouraging oncologic outcomes and low side effect when compared to those obtained by standard chemoradiation treatment for IB2, IIA2, IIB stage cervical carcinoma.

Author Disclosure: G. Cheng: None. M. He: None. H. Song: None. X. Sun: None.

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TU_13_3447 - Neoadjuvant Chemotherapy Followed By Surgery/Chemoradiotherapy Versus Radical Chemoradiotherapy in Locally Advanced Cervical Carcinoma: A Retrospective Multicenter Study of 388 Patients



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