Chemoradiation followed by surgery: its role in local control in advanced cervical cancer
Jurado M., Martínez-Monge R., López-García G., Azinovic I., Aristu J., Brugarolas A.
Department of Gynecology, Clínica Universitaria de Navarra, Pamplona, Spain.
The aim of this study was to improve local control and consequently survival, by using chemoradiation followed by surgery.
After a median follow-up of 57+ months, 95% CI (9-111) five year overall survival (OS) was 81.8%, 90% and 85.7% in stage Ib2-IIa bulky, IIb and III-IVa, respectively (p = NS). Disease-free survival (DFS) was 81.8% 80% and 71.4% (p = NS) and disease-free survival of local failure (DFSLF) was 95.4%, 80% and 100% (p = NS) for stage Ib2-IIa, bulky, IIb and III-IVa respectively. Distant metastases were present in every group, ranging from 13.6% to 17% in the early bulky and advanced groups respectively.
Pathologic findings revealed complete response (CR) (no residual disease or scattered microscopic tumoral foci) in 27/40 (67%), and partial response (PR) in 11/40 (27%). According to the pathologic response, DFS was 92.6% and 50% (p = 0.0029) and DFSLF was 100% and 77.8% (p = 0.0127) in complete and partial response respectively. This therapeutical approach promoted a high rate of pathologic complete response (PCR) PCR as well as of local control in this group at high risk for recurrence.
CITATION Rays. 1998 Jul-Sep;23(3):508-21