Document Type : Research Articles
Authors
1
Radiation Oncology Section, Lampang Cancer Hospital, Thailand.
2
Department of Obstetrics and Gynecology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Thailand.
3
Women’s Health Center, MedPark Hospital, Bangkok, Thailand.
4
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Thailand.
5
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine Chiang Mai University, Thailand.
6
Radiation Oncology Section, Chonburi Cancer Hospital, Thailand.
7
Gynecologic Oncology section, Lampang Cancer Hospital, Thailand.
8
Radiation Oncology Section, Lopburi Cancer Hospital, Thailand.
9
Radiation Oncology Section, Bhumibol Adulyadej Hospital, Thailand.
10
Department of Obstetrics and Gynecology, Prince of Songkla University, Thailand.
11
Obstetrics and Gynecology Section, Bhumibol Adulyadej Hospital, Thailand.
12
Obstetrics and Gynecology Section, Rajburi Hospital, Thailand.
Abstract
Objectives: To evaluate the type of salvage treatment and outcomes of patients with locally advanced cervical cancer who failed treatment with concurrent chemoradiation with or without adjuvant chemotherapy. Methods: This was post hoc analyses of data from the randomized trial which included 259 patients who had FIGO stage IIB-IVA and had either pelvic radiation therapy concurrent with cisplatin followed by observation or paclitaxel plus carboplatin. Data of the patients who failed primary treatment were collected: type of salvage treatments, time to progress after salvage therapy, progression-free (PFS) and overall survivals (OS). Results: After primary treatment, 85 patients had either persistence (36.5%), progression (18.8%), or recurrences (44.7%). The sites of failure were loco/regional in 52.9%, systemic failure in 30.6%, and loco-regional and systemic in 16.5%. Chemotherapy was given in 51.8%, being the sole therapy in 34.1%. Majority were combination agents (31.8%), with paclitaxel/carboplatin as the most common regimen. Radiation to the metastatic sites along with chemotherapy was used in 14.1% whereas palliative radiation therapy or supportive care was used in approximately 10% of each. The median time from the start of salvage treatment to progression was 9.2 months (range 0.2-64.0 months) with median PFS of 11.2 months (95% CI, 7.2-15.3 months). Median overall survival 27.3 months (95% CI, 4.4-69.6 months). Conclusions: Chemotherapy, either alone or with radiation therapy, was the most common salvage treatment in LACC after failure from primary treatment. The time to progress and PFS were less than 1 year with OS of approximately 2 years.
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