J Gynecol Oncol.  2020 Apr;31(3):e35. 10.3802/jgo.2020.31.e35.

Chemoradiotherapy is not superior to radiotherapy alone after radical surgery for cervical cancer patients with intermediate-risk factor

• Kim H
• Park W
• Kim YS
• Kim YJ

• KMID: 2500483
• DOI: http://doi.org/10.3802/jgo.2020.31.e35

Abstract

Objectives
There is no consensus on whether giving adjuvant concurrent chemoradiotherapy (CCRT) is more effective than adjuvant radiotherapy (RT) alone in patients with early stage cervical cancer and intermediate-risk factor(s). The purpose of this study was to evaluate survival difference according to adjuvant treatment in the intermediate-risk group.
Methods
From 2000 to 2014, the medical records of patients with stage IB–IIA cervical cancer and a history of radical hysterectomy with pelvic lymph node dissection, followed by pelvic RT at a dose ≥40 Gy were retrospectively reviewed. Among these, 316 patients with one or more intermediate-risk factor(s) and no high-risk factors were included. The criteria defined the intermediate-risk group as those patients with any of the following intermediate-risk factors: lymphovascular space involvement, over one-half stromal invasion, or tumor size ≥4 cm.
Results
The median follow-up duration was 70 months (range: 3–203 months). According to adjuvant treatment (adjuvant RT alone vs. adjuvant CCRT), the 5-year recurrence-free survival rates (90.8% vs. 88.9%, p=0.631) and 5-year overall survival rates (95.9% vs. 91.0%, p=0.287) did not show a significant difference in patients with any of the intermediate-risk factors. In multivariate analysis, a distinct survival difference according to adjuvant treatment was not found regardless of the number of risk factors.
Conclusion
The present study showed that giving RT together with chemotherapy is not more effective than RT alone for stage IB–IIA cervical cancer patients with intermediate-risk factor(s).

Keyword

Cervical Cancer; Adjuvant Radiotherapy; Risk Factor; Survival Analysis