Results of Radiation Alone Versus Neoadjuvant Chemotherapy and Radiation in Locally Advanced Stage of Uterine Cervical Cancer

Kim, Jin Hee; Choi, Tae Jin; Kim, Ok Bae

Abstract

PURPOSE
This is retrospective study to compare the results of radiation therapy alone and neoadjuvant chemotherapy and radiation in advanced stage of uterine cervical cancer.
MATERIALS AND METHODS
Seventy-six patients who were treated with definitive radiation therapy for locally advanced cervical cacinoma between June 1988 and December 1993 at the department of radiation oncology, Keimyung University Dong-san Hospital. Thirty six patients were treated with radiation therapy alone and forty patients were treated with cisplatin based neoadjuvant chemotherapy and radiation therapy. According to FIGO staging system, there were 48 patients in stage IIb, 3 patients in stage IIIa, 23 patients in stage IIIb and two patients in stage IVa with median age of 53 years old. Follow-up periods ranged from 7 to 95 months with median 58 months.
RESULTS
Complete response (CR) rate were 86.1% in radiation alone group and 80% in chemoradiation group. There was no statistical difference in CR rate between the two groups. Overall five-year survival rate was 67.3%. According to stage, overall five-year survival rates were 74% in stage IIb, 66.7% in stage IIIa, 49.8% in stage IIb, 50% in stage IVa. According to treatment modality overall five year survival rates were 74.1% in radiation alone and 61.4% in chemoradiation group (P=0.4). Five year local failure free survival rates were 71.5% in radiation alone group and 60% in chemoradiation group (P=0.17). Five year distant metastasis free survival rates were 80.7% in radiation alone group and 89.9% in chemoradiation group (P=0.42). Bone marrow suppression (more than grade II) was noted in 4 patients (11.1%) of radiation alone and 9 patients (22.5%) of chemoradiation group. Grade II vesical complication was noted in 3 cases of radiaion alone group and 1 case of chemoradiation group. Grade II retal complication was noted in 5 patients of radiation group and 4 patients in chemoradiation group. Bowel obstruction treated with conservative treatment (1 patient) and bowel perforation treated with surgery (1 patient) were noted in radiation alone group. There was no statistical difference in complication between two groups.
CONCLUSION
There was no statistical difference in survival, failure and complication between neoadjuvant chemotherapy and radiation versus radiation alone in locally advanced uterine cervical carcinoma.