A RANDOMIZED TRIAL OF CHEMOTHERAPY FOLLOWED BY PELVIC RADIATION-THERAPY IN STAGE-IIIB CARCINOMA OF THE CERVIX

被引:211
作者
SOUHAMI, L
GIL, RA
ALLAN, SE
CANARY, PCV
ARAUJO, CMM
PINTO, LHJ
SILVEIRA, TRP
机构
[1] INST NACL CANC,DEPT RADIAT ONCOL,RIO DE JANEIRO,BRAZIL
[2] INST NACL CANC,DEPT MED ONCOL,RIO DE JANEIRO,BRAZIL
[3] INST NACL CANC,DEPT EPIDEMIOL,RIO DE JANEIRO,BRAZIL
关键词
D O I
10.1200/JCO.1991.9.6.970
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Because of the poor results in stage III B carcinoma of the cervix with standard treatment using radiotherapy alone, we designed a randomized trial to determine whether administration of chemotherapy before pelvic irradiation would improve survival. Between May 1984 and August 1986, 107 patients with previously untreated squamous cell carcinoma were randomly assigned, after stratification by age ( < 50 v > 50 years), extent of parametrial involvement (unilateral v bilateral), and lymphangiographic findings (negative v positive) to pelvic radiotherapy (RT; arm A) or three cycles of chemotherapy (CT; bleomycin, vincristine, mitomycin, and cisplatin [BOMP]), followed by the same radiotherapy regimen (CT + RT; arm B). The groups were balanced by age, performance status, extent of parametrial involvement, bulkiness of cervi-cal disease, nodal involvement, and presence of hydronephrosis. Minimal follow-up is 34 months. A complete local response was observed in 32.5% of the patients in arm A and in 47% of the patients in arm B (P = .19). Overall 5-year survival rates were 39% for the RT arm and 23% for the CT + RT approach (P = .02). Toxicity was severe in arm B and included fatal pulmonary toxicity in four patients. Locoregional and distant failures were similar in both groups. We conclude that, despite a satisfactory response rate, neoadjuvant BOMP chemotherapy adversely affects survival in stage III B cervical cancer and is associated with unacceptable toxicity. © 1991 by American Society of Clinical Oncology.
引用
收藏
页码:970 / 977
页数:8
相关论文
共 49 条
[1]  
ALBERTS DS, 1981, CANCER CLIN TRIALS, V4, P313
[2]  
ALBERTS DS, 1987, CERVIX CANCER, P161
[3]   CHEMORADIOTHERAPY IN PATIENTS WITH LOCALLY ADVANCED NASOPHARYNGEAL CARCINOMA - A RADIATION-THERAPY ONCOLOGY GROUP-STUDY [J].
ALSARRAF, M ;
PAJAK, TF ;
COOPER, JS ;
MOHIUDDIN, M ;
HERSKOVIC, A ;
AGER, PJ .
JOURNAL OF CLINICAL ONCOLOGY, 1990, 8 (08) :1342-1351
[4]   BLEOMYCIN, VINCRISTINE, MITOMYCIN-C, AND CISPLATIN IN THE MANAGEMENT OF GYNECOLOGICAL SQUAMOUS-CELL CARCINOMAS [J].
BELINSON, JL ;
STEWART, JA ;
RICHARDS, AL ;
MCCLURE, M .
GYNECOLOGIC ONCOLOGY, 1985, 20 (03) :387-393
[5]   STAGE-III CARCINOMA OF CERVIX - THE IMPORTANCE OF INCREASING AGE AND EXTENT OF PARAMETRIAL INFILTRATION [J].
BENSTEAD, K ;
COWIE, VJ ;
BLAIR, V ;
HUNTER, RD .
RADIOTHERAPY AND ONCOLOGY, 1986, 5 (04) :271-276
[6]   RANDOMIZED TRIAL OF 3 CISPLATIN DOSE SCHEDULES IN SQUAMOUS-CELL CARCINOMA OF THE CERVIX - A GYNECOLOGIC ONCOLOGY GROUP-STUDY [J].
BONOMI, P ;
BLESSING, JA ;
STEHMAN, FB ;
DISAIA, PJ ;
WALTON, L ;
MAJOR, FJ .
JOURNAL OF CLINICAL ONCOLOGY, 1985, 3 (08) :1079-1085
[7]   HYPERBARIC-OXYGEN THERAPY FOR CARCINOMA OF THE CERVIX - STAGE-IIB, STAGE-IIIA, STAGE-IIIB AND STAGE-IVA - RESULTS OF A RANDOMIZED STUDY BY THE RADIATION-THERAPY ONCOLOGY GROUP [J].
BRADY, LW ;
PLENK, HP ;
HANLEY, JA ;
GLASSBURN, JR ;
KRAMER, S ;
PARKER, RG .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1981, 7 (08) :991-998
[8]  
BRENNER D, 1987, CERVIX CANC, P137
[9]  
BRUMINI R, 1982, CANCER BRASIL DADOS
[10]  
BUSH RS, 1978, BRIT J CANCER, V37, P302