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This article is part of the supplement: 24th Annual Meeting of the National Cancer Institute of Mexico

Open Access Meeting abstract

Chemoradiation with cisplatin followed by either brachytherapy or radical hysterectomy. A non-randomized comparison in FIGO stages IB2-IIA

Lucely Cetina14, Alicia Garcia1, Jesús Uribe1, Myrna Candelaria1, Carlos Lopez-Graniel2, Aaron Gonzalez2, David Cantu2, Lesbia Rivera3, Jose Hinojosa3 and Alfonso Dueñas-Gonzalez*

Author Affiliations

1 Division de Investigación Clinica, Instituto Nacional de Cancerología, México

2 Department of Gynecology Oncology, Instituto Nacional de Cancerología, México

3 Division of Radiation Oncology, Instituto Nacional de Cancerología, México

4 Unit of Biomedical Research on Cancer, Instituto de Investigaciones Biomédicas, Universidad Nacional Autonóma de México, Instituto Nacional de Cancerología, México

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BMC Cancer 2007, 7(Suppl 1):A19  doi:10.1186/1471-2407-7-S1-A19


The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1471-2407/7/S1/A19


Published:5 February 2007

© 2007 Cetina et al; licensee BioMed Central Ltd.

Background

The current standard of treatment for locally advanced cervical cancer consists of external radiation plus brachytherapy concurrent with weekly applications of cisplatin. On the other hand, current evidence suggests that preoperative chemoradiation is at least as effective as the standard treatment. Because limitations in the availability of brachytherapy in Mexico and many other developing countries, it is of major interest to determine whether a radical hysterectomy after external chemoradiation has superior or at least equivalent results in terms of survival to chemoradiation and brachytherapy. In FIGO stages IB2-IIA patients.

Patients and methods

This is a non-randomized comparison of both treatment modalities. The data of preoperative chemoradiation modality was taken from the cisplatin arm of a randomized phase II study we performed comparing preoperative chemoradiation with cisplatin against cisplatin/gemcitabine (IJROBP 2005). These forty patients were paired against a cohort of 40 patients treated with external radiation and cisplatin plus brachytherapy. In both groups, the dose of external radiation was 50 Gy in 2 Gy fractions and cisplatin was dosed at 40 mg/m2 for six weekly applications. Survival was analyzed with the Kaplan-Meier method and curves compared with the Log-rank test.

Results

There were no significant differences in the clinicopathological characteristics of the patients. Mean age was 45 years (range 24 – 70). In both groups the histologies were squamous cell carcinoma (70%), adenocarcinoma (20%), and adenosquamous (10%). Stage distribution according to the FIGO was as follows: IB2, 22.5%; IIA, 10%; IIB, 67.5%, in both groups. Overall, 100% of patients completed external beam, and surgery or intracavitary brachyterapy. The majority of patients received the planned six courses of weekly cisplatin. At median follow-up (28 months; range 2–58 months), overall survival is 78% and 75% (p > 0.05) for the surgical and brachytherapy groups of patients.

Conclusion

The results of this non-randomized comparison suggest that these treatment modalities are equivalent in terms of survival. A randomized study is ongoing to confirm these results.