Summary
Background
Given the lack of primary and secondary prevention programs and cancer awareness in general, cervical cancer remains one of the main causes of cancer-related death in developing countries, such as Bosnia and Herzegovina. Optimization of combinations of external radiation therapy (ERT), brachytherapy and chemotherapy is still needed to improve outcomes in the treatment of advanced cervical cancer.
Patients and methods
We retrospectively analyzed 48 consecutive patients with Fédération Internationale de Gynecologie et d’Obstetrique (FIGO) 2009 stage IB2-IVA, who were treated with primary concomitant chemobrachyradiotherapy (CCBRT) and consolidation chemotherapy at the Department of Oncology, University Hospital Mostar, Bosnia and Herzegovina between December 2012 and June 2020. Patients were treated with ERT plus two cycles of concomitant chemobrachytherapy with ifosfamide and cisplatin and low-dose rate (LDR) brachytherapy followed by four cycles of consolidation chemotherapy at 3‑week intervals. We evaluated local control rate (LCR), disease-free survival (DFS), overall survival (OS), disease-specific survival (DSS) and toxicity.
Results
After 45.5 months (interquartile range, IQR = 47 months) of median follow-up, 5‑year DFS was 72.8% (95% confidence interval. CI 59–78%), OS was 76.6% (95% CI 60–79%), and DSS was 88% (95% CI 71–86%) with acceptable toxicity. LCR was 94%.
Conclusion
Primary CCBRT and consolidation chemotherapy applied in standard clinical practice in the treatment of locally advanced cervical cancer (LACC) produce respectable outcomes.
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Acknowledgements
The authors would like to thank patients who participated in this study. The authors also want to thank Žarko Bajić for the help in statistical data analysis.
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KT contributed to the design of the study, data collection, data analysis, writing and manuscript revision. EV contributed to the design of the study, data analysis, writing and manuscript revision. GBJ and AP contributed to the data collection, data analysis and manuscript revision. IM and DS contributed to the data analysis and manuscript revision. IL performed the statistical analyses. All co-authors have read and approved the final version of the manuscript.
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K. Tomić, G. Berić Jozić, A. Parić, I. Marijanović, I. Lasić, D. Soldo and E. Vrdoljak declare that they have no competing interests.
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Tomić, K., Berić Jozić, G., Parić, A. et al. Chemobrachyradiotherapy and consolidation chemotherapy in treatment of locally advanced cervical cancer. Wien Klin Wochenschr 133, 1155–1161 (2021). https://doi.org/10.1007/s00508-021-01958-0
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DOI: https://doi.org/10.1007/s00508-021-01958-0