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Outcomes and toxicities for the treatment of stage IVB cervical cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

The prognosis of stage IVB cervical cancer is generally poor. In the current study, treatment outcomes were evaluated in patients with International Federation of Gynecologic Oncology stage IVB cervical cancer treated with radiotherapy and chemotherapy for progression-free survival (PFS) and treated-related toxicities.

Study Design

The medical records of the patients with stage IVB cervical cancer who were treated at the National Cancer Center, South Korea were reviewed retrospectively. From February 2002 to February 2010, 45 patients were diagnosed with FIGO stage IVB cervical cancer. Survival and toxicities were compared between the 13 patients with concomitant chemoradiotherapy (CCRT) with weekly cisplatin versus 20 patients with CCRT with 5-fluorouracil/cisplatin.

Results

Initial treatment included weekly cisplatin-CCRT, 5-fluorouracil/cisplatin-CCRT, neoadjuvant chemotherapy, and radiotherapy with subsequent combination chemotherapy in 13, 20, 4, and 5 patients, respectively. Overall survival (OS) and PFS were 26.2 and 6.7 months, respectively. There was no statistical difference in OS (p = 0.47) and PFS (p = 0.64) between the weekly cisplatin-CCRT and 5-fluorouracil/cisplatin-CCRT groups; however, the incidence of anemia >grade 3 as an acute toxicity was higher in the 5-fluorouracil/cisplatin-CCRT chemotherapy regimen group than the weekly cisplatin-CCRT group (p = 0.03). Acute toxicity >grade 2 showed a tendency to be higher in the 5-fluorouracil/cisplatin-CCRT group. Based on multivariate analysis, poor performance status was the only independent prognostic factor of OS (p = 0.03, 9.77; 95% CI 1.3–73.3) and PFS (p = 0.04, 9.58; 95% CI 1.14–81.26).

Conclusions

CCRT using combination chemotherapeutic agents may not have survival advantage over single agent cisplatin-based CCRT. Further improvement in treatment is needed to increase survival outcomes and to decrease treatment-related toxicities in patients with stage IVB cervical cancer.

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Acknowledgment

This study was supported by Grant No. 1110540 from the National Cancer Center, Korea.

Conflict of interest

The authors declare that there are no conflicts of interest.

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Authors and Affiliations

  1. Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 323 Illsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Korea

    Jong Ha Hwang, Myong Cheol Lim, Sang-Soo Seo, Sokbom Kang, Sang-Yoon Park & Joo-Young Kim

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  1. Jong Ha Hwang
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  2. Myong Cheol Lim
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  3. Sang-Soo Seo
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  4. Sokbom Kang
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Correspondence to Joo-Young Kim.

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Hwang, J.H., Lim, M.C., Seo, SS. et al. Outcomes and toxicities for the treatment of stage IVB cervical cancer. Arch Gynecol Obstet 285, 1685–1693 (2012). https://doi.org/10.1007/s00404-011-2173-6

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  • DOI: https://doi.org/10.1007/s00404-011-2173-6

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