바로가기  >

이달의 연구자 바로가기 Click!

Abstract
Objective: Radiotherapy dose-escalation using intensity-modulated radiotherapy (IMRT) has been necessary to improve treatment results in cervical cancer.

Methods: This was a phase II prospective clinical trial. 88 patients with FIGO II-IVa cervical cancer were enrolled in a single center. They received high-dose (60 Gy) IMRT with weekly cisplatin to the primary tumor and clinically positive nodes followed by intracavitary radiation. The primary endpoint was 30-month PFS rate (Target; 82%, an increase of 20% compared to GOG 120 trial using standard-dose radiotherapy). Secondary endpoints were tumor response, toxicity, recurrence, distant metastasis, and overall survival.

Results: Progression-free survival rate at 30 months was 82.8%. Overall survival, locoregional recurrence, distant metastasis, and para-aortic recurrence rates at 30 months were 93.6%, 8.2%, 9.2%, and 2.4%, respectively. Forty-five (51.1%) of 88 patients achieved downstaging on MRI during radiotherapy and 80 (90.9%) patients had clinically complete response at three months after high-dose IMRT and intracavitary radiotherapy. The 30-month recurrence-free survival (92.9% vs. 73.1%, P = 0.009) and overall survival (100% vs. 87.0%, P = 0.006) were significantly higher in the downstaged group than in the non-downstaged group during radiotherapy. Grade 3 or higher hematologic toxicity was found in 11 (12.5%) patients and grade 3 or higher non-hematologic toxicity was found in 3 (3.4%) patients. Fourteen had chronic urinary (8.0%), intestinal (5.7%) toxicity, pelvic insufficiency fracture (2.3%) or vesicovaginal fistula (2.3%).

Conclusion: High-dose (60 Gy) IMRT with concurrent weekly cisplatin in locally advanced cervical cancer yielded favorable progression-free survival outcome. Tumor response during radiotherapy can be a significant prognostic factor for PFS.

Clinical trial information: This prospective trial is registered at ClinicalTrials.gov Identifier: NCT02993653.

본 연구에서 시행된 치료의 개요도입니다.

Affiliations

Hyo Chun Lee 1, Jae Won Jeong 1, Joo Hwan Lee 1, Sung Hwan Kim 1, Dong Chun Park 2, Joo Hee Yoon 2, Sang Il Kim 2, Jong Hoon Lee 3
1Department of Radiation Oncology, St. Vincet's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
2Department of Obstetrics and Gynecology, St. Vincet's Hospital, The Catholic University of Korea, Seoul, Republic of Korea.
3Department of Radiation Oncology, St. Vincet's Hospital, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: koppul@catholic.ac.kr.