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Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer: toxicity, tumour response and outcome

Katrien Vandecasteele UGent, Amin Makar UGent, Rudy Van den Broecke UGent, LOUKE DELRUE UGent, Hannelore Denys UGent, Kathleen Lambein UGent, Bieke Lambert UGent, Marc Van Eijkeren UGent, PHILIPPE TUMMERS UGent and Gert De Meerleer UGent (2012) STRAHLENTHERAPIE UND ONKOLOGIE. 188(7). p.576-581
abstract
The goal of this work was to evaluate the feasibility and outcome of intensity-modulated arc therapy +/- A cisplatin (IMAT +/- A C) followed by hysterectomy for locally advanced cervical cancer. A total of 30 patients were included in the study. The primary tumour and PET-positive lymph node(s) received a simultaneous integrated boost. Four weeks after IMAT +/- A C treatment, response was evaluated. Resection consisted of hysterectomy with or without lymphadenectomy. Tumour response, acute and late radiation toxicity, postoperative morbidity and outcome were evaluated. All hysterectomy specimens were macroscopically tumour-free with negative resection margins; pathological complete response was 40%. In 2 patients, one resected lymph node was positive. There was no excess in postoperative morbidity. Apart from two grade 3 hematologic toxicities, no grade 3 or 4 acute radiation toxicity was observed. No grade 3, 1 grade 4 (4%) intestinal, and 4 grade 3 (14%) urinary late toxicities were observed. The 2-year local and regional control rates were 96% and 100%, respectively. The 2-year distant control rate was 92%. Actuarial 2-year progression free survival rate was 89%. Actuarial 1- and 2-year overall survival rates were 96% and 91%, while 3-year overall survival was 84%. Surgery after IMAT +/- A C is feasible with low postoperative morbidity and radiation toxicity. Local, regional, distant control and survival rates are promising.
Please use this url to cite or link to this publication:
author
organization
alternative title
Intensitätsmodulierte Rotationstherapie mit Cisplatin als neoadjuvante Behandlung beim primären, inoperablen Zervixkarzinom : Toxizität, Tumoransprechen und Behandlungsergebnis
year
type
journalArticle (original)
publication status
published
subject
keyword
Acute toxicity, Treatment outcome, RADIATION-THERAPY, UTERINE CERVIX, CONCOMITANT CHEMORADIATION, RANDOMIZED-TRIAL, CARCINOMA, SURGERY, COMPLICATIONS, PROSTATE-CANCER, RADIOTHERAPY, ONCOLOGY-GROUP, Radiotherapy, Hysterectomy, Uterine cervical neoplasms
journal title
STRAHLENTHERAPIE UND ONKOLOGIE
Strahlenther. Onkol.
volume
188
issue
7
pages
576 - 581
Web of Science type
Article
Web of Science id
000305468800006
JCR category
RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
JCR impact factor
4.163 (2012)
JCR rank
12/119 (2012)
JCR quartile
1 (2012)
ISSN
0179-7158
DOI
10.1007/s00066-012-0097-0
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2974299
handle
http://hdl.handle.net/1854/LU-2974299
date created
2012-08-23 10:14:04
date last changed
2015-02-02 13:51:12
@article{2974299,
  abstract     = {The goal of this work was to evaluate the feasibility and outcome of intensity-modulated arc therapy +/- A cisplatin (IMAT +/- A C) followed by hysterectomy for locally advanced cervical cancer. 
A total of 30 patients were included in the study. The primary tumour and PET-positive lymph node(s) received a simultaneous integrated boost. Four weeks after IMAT +/- A C treatment, response was evaluated. Resection consisted of hysterectomy with or without lymphadenectomy. Tumour response, acute and late radiation toxicity, postoperative morbidity and outcome were evaluated. 
All hysterectomy specimens were macroscopically tumour-free with negative resection margins; pathological complete response was 40\%. In 2 patients, one resected lymph node was positive. There was no excess in postoperative morbidity. Apart from two grade 3 hematologic toxicities, no grade 3 or 4 acute radiation toxicity was observed. No grade 3, 1 grade 4 (4\%) intestinal, and 4 grade 3 (14\%) urinary late toxicities were observed. The 2-year local and regional control rates were 96\% and 100\%, respectively. The 2-year distant control rate was 92\%. Actuarial 2-year progression free survival rate was 89\%. Actuarial 1- and 2-year overall survival rates were 96\% and 91\%, while 3-year overall survival was 84\%. 
Surgery after IMAT +/- A C is feasible with low postoperative morbidity and radiation toxicity. Local, regional, distant control and survival rates are promising.},
  author       = {Vandecasteele, Katrien and Makar, Amin and Van den Broecke, Rudy and DELRUE, LOUKE and Denys, Hannelore and Lambein, Kathleen and Lambert, Bieke and Van Eijkeren, Marc and TUMMERS, PHILIPPE and De Meerleer, Gert},
  issn         = {0179-7158},
  journal      = {STRAHLENTHERAPIE UND ONKOLOGIE},
  keyword      = {Acute toxicity,Treatment outcome,RADIATION-THERAPY,UTERINE CERVIX,CONCOMITANT CHEMORADIATION,RANDOMIZED-TRIAL,CARCINOMA,SURGERY,COMPLICATIONS,PROSTATE-CANCER,RADIOTHERAPY,ONCOLOGY-GROUP,Radiotherapy,Hysterectomy,Uterine cervical neoplasms},
  language     = {eng},
  number       = {7},
  pages        = {576--581},
  title        = {Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer: toxicity, tumour response and outcome},
  url          = {http://dx.doi.org/10.1007/s00066-012-0097-0},
  volume       = {188},
  year         = {2012},
}

Chicago
Vandecasteele, Katrien, Amin Makar, Rudy Van den Broecke, LOUKE DELRUE, Hannelore Denys, Kathleen Lambein, Bieke Lambert, Marc Van Eijkeren, Philippe Tummers, and Gert De Meerleer. 2012. “Intensity-modulated Arc Therapy with Cisplatin as Neo-adjuvant Treatment for Primary Irresectable Cervical Cancer: Toxicity, Tumour Response and Outcome.” Strahlentherapie Und Onkologie 188 (7): 576–581.
APA
Vandecasteele, Katrien, Makar, A., Van den Broecke, R., DELRUE, L., Denys, H., Lambein, K., Lambert, B., et al. (2012). Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer: toxicity, tumour response and outcome. STRAHLENTHERAPIE UND ONKOLOGIE, 188(7), 576–581.
Vancouver
1.
Vandecasteele K, Makar A, Van den Broecke R, DELRUE L, Denys H, Lambein K, et al. Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer: toxicity, tumour response and outcome. STRAHLENTHERAPIE UND ONKOLOGIE. 2012;188(7):576–81.
MLA
Vandecasteele, Katrien, Amin Makar, Rudy Van den Broecke, et al. “Intensity-modulated Arc Therapy with Cisplatin as Neo-adjuvant Treatment for Primary Irresectable Cervical Cancer: Toxicity, Tumour Response and Outcome.” STRAHLENTHERAPIE UND ONKOLOGIE 188.7 (2012): 576–581. Print.